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MONIC LISSETTE WILDASIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
9040 JACKSON AVE, TACOMA, WA 98431-0001
(713) 962-7990
Mailing address
299 KINGSPOINT DR APT 127, EL PASO, TX 79912-6511
(713) 962-7990

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary

Other

Enumeration date
07/20/2023
Last updated
03/23/2026
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