Wilson, Amanda Louise

Wilson, Amanda Louise is an individual health care provider with primary practice located at 4016 52Nd Avenue Ct Nw , Gig Harbor WA 98335-7632. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Addiction Medicine. Allopathic & Osteopathic Physicians / Addiction Medicine is her primary health care specialty. Wilson, Amanda Louise can be contacted via phone (413) 221-6113.

Contact Information

Primary practice address
4016 52Nd Avenue Ct Nw Gig Harbor WA 98335-7632
Phone: (413) 221-6113
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 205246 Massachusetts
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 049592 Connecticut
Allopathic & Osteopathic Physicians / Addiction Medicine 207RA0401X 4301505786 Michigan
Allopathic & Osteopathic Physicians / Addiction Medicine 207RA0401X 60935430 Washington

Profile Details

NPI number 1821066085
LBN Legal business name Wilson, Amanda Louise
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 14th, 2006
Last updated May 3rd, 2022 - about 2 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821066085 NPPES
Massachusetts MEDICAID 0126748
Massachusetts MEDICAID 003126944

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