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Anne Janette Wilson

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

1201 Pacific Ave Ste 400, Tacoma, WA 98402-4381

PECOS Enrollment

This provider is enrolled in PECOS as ANNE WILSON.

Based on the most recent information from CMS, provider Anne Janette Wilson is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 6 days ago.

Profile Details

Provider ID
1326718701
Provider Type
Individual
Full Name
Wilson, Anne Janette
Credential
PA-C

Gender
Female
Sole Proprietor
Yes
Enumeration Date
9/16/2021
Last Updated
9/16/2021

Contact Information

Practice Location

1201 Pacific Ave Ste 400, Tacoma, WA 98402-4381

(970) 402-7988

Unlisted Fax

Mailing Location

1449 Runge Ave, Blaine, WA 98230-9507

(970) 402-7988

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 61224506 Washington

Provider Identifiers

ID	Description	Issuer
ID 61224506	Description Other	Issuer STATE TEMPORARY LICENSE Washington

Anne Janette Wilson

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Sayers, Katie S

Kaur, Sabreena

Aguirre, Yareli

Denty, Sara Diane

Wilcox, Tracey Lynn

Puett, Leonard Robert

Green, Tenesha

Fraser, Stephanie Kieu

Wambuzi, Selemani E

Zapatka, Jaryd