Provider Demographics
NPI:1295889962
Name:WILKINSON, WILLIAM RONALD (EDD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:RONALD
Last Name:WILKINSON
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17900 TALBOT RD S
Mailing Address - Street 2:SUITE 102
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-8212
Mailing Address - Country:US
Mailing Address - Phone:253-351-2194
Mailing Address - Fax:
Practice Address - Street 1:17900 TALBOT RD S
Practice Address - Street 2:SUITE 102
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-8212
Practice Address - Country:US
Practice Address - Phone:253-351-2194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00000243103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist