SearchWashington163W00000X

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