MEDICARE: BENJAMIN THOMAS WILSON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	MD70074771	WA
2	207L00000X	Anesthesiology Physician	MTL005401	DC

General Provider Information

NPI Number	:	1629539143
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BENJAMIN THOMAS WILSON MD

Provider Business Mailing Address
First Line	:	1717 S J ST
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98405-4933
Country	:	US
Telephone Number	:	253-426-6341
Fax Number	:	253-426-6344

Provider Business Practice Location Address
First Line	:	1717 S J ST
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98405-4933
Country	:	US
Telephone Number	:	253-426-6341
Fax Number	:	253-426-6344

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2019
Last Update Date	:	03/03/2026

Similar Medicare Providers

1487114195 — DR. JAMES LOGAN LAWRENCE DO
Practice Location Address:

1717 S J ST
TACOMA, WA
98405-4933

Practice Phone: 253-426-6341
Practice Fax: 253-426-6344

1013106582 — MS. JESSICA WAI-YING TAM MD
Practice Location Address:

1717 S J ST
TACOMA, WA
98405-4933

Practice Phone: 253-426-6341
Practice Fax: 253-426-6344

1689951550 — MS. AUDRY JEAN KAHLSTROM ARNP
Practice Location Address:

1717 S J ST
TACOMA, WA
98405-4933

Practice Phone: 253-426-6341
Practice Fax: 253-426-6344

1952309098 — FRANCISCAN HEALTH SYSTEM
Practice Location Address:

1717 S J ST
TACOMA, WA
98405-4933

Practice Phone: 253-573-7143
Practice Fax: 253-573-7059

1972593721 — DR. J KELLY MARTIN JR. PHARM.D.
Practice Location Address:

1717 S J ST , PHARMACY DEPT
TACOMA, WA
98405-4933

Practice Phone: 253-426-6692
Practice Fax: 253-426-4949

1407846108 — DR. TONY JERROLD CASANOVA PHARM.D.
Practice Location Address:

1717 S J ST , ST. JOSEPH MEDICAL CENTER (INPATIENT PHARMACY)
TACOMA, WA
98405-4933

Practice Phone: 253-426-6692
Practice Fax:

Directions to “ BENJAMIN THOMAS WILSON MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.