Individual
BRUCE A. WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
209 MARTIN LUTHER KING JR WAY, TACOMA, WA 98405-4265
(253) 596-3300
Mailing address
209 MARTIN LUTHER KING JR WAY, TACOMA, WA 98405-4265
(253) 596-3300
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD00034129
WA
208M00000X
Hospitalist Physician
MD00034129
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8193179
—
WA
Enumeration date
01/02/2007
Last updated
05/11/2021
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