Wilson, Edith Diane
Wilson, Edith Diane is an individual health care provider with primary practice located at 615 Lilly Rd Ne Ste 175 , Olympia WA 98506-5179. She recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as her primary health care specialty. Wilson, Edith Diane can be contacted via phone (360) 486-6772.Contact Information
Primary practice address
615 Lilly Rd Ne Ste 175
Olympia WA 98506-5179
Phone: (360) 486-6772
Fax: (360) 486-6775
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Urology | 208800000X | 5500A | Wyoming |
| Allopathic & Osteopathic Physicians / Urology | 208800000X | 36402 | Colorado |
Profile Details
| NPI number | 1972602969 |
|---|---|
| LBN Legal business name | Wilson, Edith Diane |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 22nd, 2006 |
| Last updated | Aug 29th, 2011 - about 13 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 | 1972602969 | NPPES |
| Wyoming | MEDICAID | 110601500 | |
| Wyoming | Other | W9209 |
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