Individual
DARRICK ALEXANDER WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
18107 HOWLING WOLF RUN, PARRISH, FL 34219-5014
(206) 650-9396
Mailing address
17721 SE 261ST ST, COVINGTON, WA 98042-8330
(206) 650-9396
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
AS45IN
FL
347C00000X
Private Vehicle
Primary
AS84GS
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
WDL62P4FF2SB
—
WA
Enumeration date
03/01/2023
Last updated
03/01/2023
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