Individual
JENNIFER GRACE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
715 NORTH PARK DRIVE, SELAH, WA 98942
(509) 698-2624
Mailing address
1809 E 14TH AVE, ELLENSBURG, WA 98926-5127
(206) 794-8710
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP61124275
WA
Other
Enumeration date
12/10/2020
Last updated
12/10/2020
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