Search › Washington › 101YA0400X
Jeff Wilson, CDP
NPI 1235515776 · on the registry since 2015
Practice
- Address
- 611 W Cota St
Shelton, WA 98584 - Phone
- (360) 426-5654
- Fax
- (360) 426-5641
- Organisation at this address
- Social Treatment Opportunity Programs Ii, Inc
Inferred from a shared address, not stated in the registry.
Registry record
- Primary taxonomy
- 101YA0400X
101YA0400X
- Licence states on file
- WA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2015-08-06
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