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NPI 1225080534

NPI 1225080534 : F DOUGLAS WILSON DC : VANCOUVER, WA

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General NPI Number Information
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    NPI Number           |    1225080534
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    Entity Type          |    Individual 
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    Provider Name        |    F DOUGLAS WILSON DC
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    05/16/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    7301 NE HWY 99 SUITE 7
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    City                 |    VANCOUVER
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    State                |    WA
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    Zip                  |    98665
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    Country              |    US
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    Telephone            |    360-573-4666
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    Fax                  |    360-573-4668
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Provider Business Mailing Address
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    Address Line         |    7301 NE HWY 99 SUITE 7
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    City                 |    VANCOUVER
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    State                |    WA
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    Zip                  |    98665
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    Country              |    US
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    Telephone            |    360-573-4666
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    Fax                  |    360-573-4668
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    111N00000X
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    Taxonomy Name        |    Chiropractor
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    License Number       |    CH00002135
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    License Number State |    WA
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