Provider Demographics
NPI:1356547475
Name:WILSON, MARNI L (AAS)
Entity type:Individual
Prefix:
First Name:MARNI
Middle Name:L
Last Name:WILSON
Suffix:
Gender:F
Credentials:AAS
Other - Prefix:
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Mailing Address - Street 1:PO BOX 24366
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-0366
Mailing Address - Country:US
Mailing Address - Phone:206-598-0502
Mailing Address - Fax:206-598-0516
Practice Address - Street 1:4245 ROOSEVELT WAY NE
Practice Address - Street 2:BOX 354745
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-6008
Practice Address - Country:US
Practice Address - Phone:206-598-2888
Practice Address - Fax:206-598-4484
Is Sole Proprietor?:No
Enumeration Date:2007-06-25
Last Update Date:2014-06-05
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant