Provider Demographics
NPI:1023806940
Name:GWEN WILSON PLLC
Entity type:Organization
Organization Name:GWEN WILSON PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GWENDOLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:206-888-4437
Mailing Address - Street 1:1833 N 105TH ST STE 101
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-8973
Mailing Address - Country:US
Mailing Address - Phone:206-888-4437
Mailing Address - Fax:206-203-1979
Practice Address - Street 1:1833 N 105TH ST STE 307
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-8973
Practice Address - Country:US
Practice Address - Phone:206-888-4437
Practice Address - Fax:206-203-1979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty