Provider Demographics
NPI:1952979056
Name:WILSON, PAIGE CHRISTY (LMT)
Entity Type:Individual
Prefix:MRS
First Name:PAIGE
Middle Name:CHRISTY
Last Name:WILSON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MISS
Other - First Name:PAIGE
Other - Middle Name:CHRISTY
Other - Last Name:FARMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1119 GROVE ST
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98270-3630
Mailing Address - Country:US
Mailing Address - Phone:425-344-9061
Mailing Address - Fax:
Practice Address - Street 1:3131 SMOKEY POINT DR STE 5B
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-2301
Practice Address - Country:US
Practice Address - Phone:360-653-9600
Practice Address - Fax:360-658-9603
Is Sole Proprietor?:No
Enumeration Date:2021-06-15
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA61143888225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist