Provider Demographics
NPI:1518913680
Name:WILSON, JAMES ALLAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ALLAN
Last Name:WILSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5920 100TH ST SW
Mailing Address - Street 2:SUITE 26
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-2751
Mailing Address - Country:US
Mailing Address - Phone:253-588-0756
Mailing Address - Fax:253-581-3787
Practice Address - Street 1:5920 100TH ST SW
Practice Address - Street 2:SUITE 26
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-2751
Practice Address - Country:US
Practice Address - Phone:253-588-0756
Practice Address - Fax:253-581-3787
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2007-08-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00026594207Q00000X, 207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics