Wilson, Adam Spach
Wilson, Adam Spach is an individual health care provider with primary practice located at 1405 Se 164Th Ave Ste 102 , Vancouver WA 98683-9644. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Wilson, Adam Spach can be contacted via phone (360) 256-4425.Contact Information
Primary practice address
1405 Se 164Th Ave Ste 102
Vancouver WA 98683-9644
Phone: (360) 256-4425
Fax: (360) 254-1844
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Otolaryngology | 207Y00000X | MD00034230 | Washington |
Profile Details
| NPI number | 1790745933 |
|---|---|
| LBN Legal business name | Wilson, Adam Spach |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 23rd, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790745933 | NPPES |
| Washington | Other | 98683A007 | TRIWEST |
| Washington | Other | 300151208 | TRIWEST |
| Washington | Other | 011826007 | TRIWEST |
| Washington | MEDICAID | 8197287 | TRIWEST |
| Washington | Other | 0130871 | TRIWEST |
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