Organization
ROBERT HARRISON WILSON MD
Active
Other names
robert h. wilson, md
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JONATHAN KABOOS (OFFICE MANAGER)
(253) 564-4157
Entity
Organization
Contact information
Practice address
4401 BRIDGEPORT WAY W, UNIVERSITY PLACE, WA 98466-4201
(253) 564-4157
(253) 564-4813
Mailing address
4401 BRIDGEPORT WAY W, UNIVERSITY PLACE, WA 98466-4201
(253) 564-4157
(253) 564-4813
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD00014627
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1214600
—
WA
Enumeration date
03/07/2008
Last updated
04/04/2016
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