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General NPI Number Information
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NPI Number | 1992518427
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Entity Type | Individual
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Provider Name | CELENA WILSON PHARMD
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Gender | Female
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Dates
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Enumeration Date | 01/29/2025
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Last Update Date | 01/29/2025
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Provider Practice Location Address
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Address Line | 525 LILLY RD NE
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City | OLYMPIA
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State | WA
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Zip | 98505-5101
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Country | US
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Telephone | 360-493-7230
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Fax |
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Provider Business Mailing Address
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Address Line | 1288 COOPER ST
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City | DUPONT
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State | WA
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Zip | 98327-8778
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Country | US
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Telephone | 253-302-0872
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Fax |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH61567798
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License Number State | WA
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