Michael Lawrence Wilson | Tacoma, WA • PECOS Search

Michael Lawrence Wilson

Counselor

Behavioral Health & Social Service Providers

3834 S 19th St, Tacoma, WA 98405-2016

(253) 396-5901 (235) 548-9728

PECOS Enrollment

Based on the most recent information from CMS, provider Michael Lawrence Wilson does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 4 days ago.

Profile Details

Provider ID
1902089972
Provider Type
Individual
Full Name
Wilson, Michael Lawrence
Title
Mr.
Credential
AA

Gender
Male
Sole Proprietor
No
Enumeration Date
12/12/2007
Last Updated
12/12/2007

Contact Information

Practice Location

3834 S 19th St, Tacoma, WA 98405-2016

Unlisted Fax

Mailing Location

5623 N 49th St, Ruston, WA 98407-3014

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 101YM0800X Primary	Description Counselor Behavioral Health & Social Service Providers	License Unlisted Issuer