Individual
CHANTEL MARIE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
10202 PACIFIC AVE S., STE 215, TACOMA, WA 98444-6573
(253) 332-8997
(253) 531-8450
Mailing address
10202 PACIFIC AVE S., STE 215, TACOMA, WA 98444-6573
(253) 332-8997
(253) 531-8450
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MA 00013633
WA
225700000X
Massage Therapist
Primary
MA00013633
WA
Other
Enumeration date
01/18/2011
Last updated
06/02/2015
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