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DR. REGINALD WENDELL WILSON M.D. NPI 1477517563


NPI Information

NPI: 1477517563
Provider Name: DR. REGINALD WENDELL WILSON, M.D.
Classification: Pathology - 207ZP0102X
Entity Type: Individual

Specialization: Anatomic Pathology & Clinical Pathology

PECOS Registration: Yes

Address:
19505 52ND AVE W
SUITE A
LYNNWOOD, WA
ZIP 98036
Phone: (206) 623-3814
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DR. Reginald Wendell Wilson, M.D. is an anatomic pathology and clinical pathology pathology in Lynnwood, WA with 39 years of experience. The provider is a pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. DR. Reginald Wendell Wilson, M.D. NPI is 1477517563. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: EMORY UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:1985

The provider's business location address is:

19505 52ND AVE W
SUITE A
LYNNWOOD, WA
ZIP 98036-409
Phone: (206) 623-3814
Fax: (206) 623-4327

The NPI 1477517563 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/14/2006 and was last updated on 5/11/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207ZP0102XPathologyAnatomic Pathology & Clinical PathologyMD 60318390WASHINGTONYes
2207ZP0102XPathologyAnatomic Pathology & Clinical Pathology030927GEORGIANo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1727301OTHERGEORGIABCBSGA PROVIDER #
2118365OTHERGEORGIAPEACH STATE HLT PLANS
3P00256641OTHERGEORGIARAILROAD MEDICARE
4297058OTHERGEORGIAWELLCARE
510049819OTHERGEORGIAAMERIGROUP
6000787652AMEDICAIDGEORGIA
7G71173MEDICARE UPINGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.