Whalio Doctors

NPI 1063879419

Andrew James Wildasin, LPN

Practitioner Licensed Vocational Nurse Tacoma, WA

Practice location

Address
9040 Reid Street, Attn: McHj-Clq-C Madigan Army Medical Center, Tacoma, WA 98431-1000
Phone
(253) 968-1110
Fax
(577) 874-1031

Registered specialties

Licensed Vocational Nurse Primary
Nursing Service Providers Taxonomy 164X00000X Licence 327772 (TX)

Registry record

NPI
1063879419
Entity type
Individual
Sex (as registered)
Male
NPI issued
15 Jan 2016
Record last updated
15 Jan 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.