Healthcare Provider Details

I. General information

NPI: 1780122200
Provider Name (Legal Business Name): LINDA WILSON RCP, RRT, RPFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2017
Last Update Date: 02/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 9TH AVE
SEATTLE WA
98104-2420
US

IV. Provider business mailing address

325 9TH AVE
SEATTLE WA
98104-2420
US

V. Phone/Fax

Practice location:
  • Phone: 206-744-3807
  • Fax: 206-744-2320
Mailing address:
  • Phone: 206-744-3807
  • Fax: 206-744-2320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225B00000X
TaxonomyPulmonary Function Technologist
License NumberLR00000974
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License NumberLR00000974
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code2279P1004X
TaxonomyPulmonary Diagnostics Registered Respiratory Therapist
License NumberLR00000974
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: