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Antonia Wilson
NPI 1174093207 · on the registry since 2018
Practice
- Address
- 12530 Vine Maple Dr Sw
Lakewood, WA 98499 - Phone
- (253) 301-0099
- Organisation at this address
- Vine Maple Care Home Llc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 3
Registry record
- Primary taxonomy
- 163W00000X
163W00000X
- Licence states on file
- WA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2018-12-02
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Washington