MR. GLENN GORDON WILSON (NPI# 1417471426) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417471426 |
| Entity Type | Individual |
| Full Name | MR. GLENN GORDON WILSON |
| Credential | CP(C)CO,BOCP |
| Practice Address |
514 S Washington St Spokane WA 99204-2620 |
| Mailing Address |
4214 S Sullivan Rd Veradale WA 99037-9187 |
| Practice Telephone | 5096243314 |
| Practice Fax Number | 5097870952 |
| Mailing Telephone | 4067500123 |
| Enumeration Date | 2017-08-01 |
| Last Update Date | 2017-08-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 224P00000X | Prosthetist | PS60602304 | WA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689676652 | Glenn M Wilson | Dentist | 146 Danbury Rd, Suite C, New Milford, CT 06776-3427 | 2005-08-10 |
| 1720401789 | Glenn Wilson | Military Health Care Provider | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2014-01-28 |
| 1245672609 | Glenn Jay Wilson | Counselor | 267 6th St, Meeker, CO 81641 | 2013-07-25 |
| 1285859801 | Glenn L Wilson | Technician/Technologist | 120 W Main St, Suite 210, Mesquite, TX 75149-4264 | 2007-04-17 |
| 1730230111 | Glenn Dean Wilson | Dentist | 4601 Brainerd Rd, Chattanooga, TN 37411-3826 | 2007-01-14 |
| 1750479754 | Glenn L Wilson | Orthopaedic Surgery | 100 Medical Center Dr., Suite 101, Gadsden, AL 35903-1130 | 2006-10-11 |
| 1831294297 | Glenn David Wilson | Counselor | 1435 N Oakland Blvd, Waterford, MI 48327-1549 | 2006-09-13 |
| Street Address |
514 S WASHINGTON ST |
| City | SPOKANE |
| State | WA |
| Zip Code | 99204-2620 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972677029 | Hanger Prosthetics & Orthotics Inc | Durable Medical Equipment & Medical Supplies | 514 S Washington St, Spokane, WA 99204-2620 | 2006-11-20 |
| 1164815981 | Bruce Alan Strelow | Orthotist | 514 S Washington St, Spokane, WA 99204-2620 | 2015-03-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982250957 | Megan Elizabeth Dibenedetto | Pharmacist | 105 West 8th Avenue, 350e, Spokane, WA 99204 | 2019-08-14 |
| 1619521168 | Evelyn R Cabon | Genetic Counselor, MS | 101 W. 8th Avenue Suite 1100, Spokane, WA 99204 | 2019-08-01 |
| 1346700655 | Christina Rose | Student in an Organized Health Care Education/Training Program | 120 W. 8th Avenue, Spokane, WA 99204 | 2019-03-22 |
| 1508339862 | Cody J French | Physical Therapist | Washington Outpatient Rehab, 507 S Washington, Spokane, WA 99204 | 2019-01-09 |
| 1730655598 | Washington Outpatient Rehabilitation, LLC | Physical Therapist | 507 S. Washington St., Suite 10, Spokane, WA 99204 | 2018-10-19 |
| 1013405547 | Joel James Hayden | Student in an Organized Health Care Education/Training Program | Providence Sacred Heart, 101 West 8th Avenue, Spokane, WA 99204 | 2018-04-30 |
| 1144694787 | Brooksjohnsonpllc | Dentist | 1004 S. Monroe Street, Ste 100, Spokane, WA 99204 | 2015-11-19 |
| 1497184196 | Kathalene M Cassels | Physician Assistant | 810 W. 5th Ave. Ste 510, Spokane, WA 99204 | 2013-11-04 |
| 1174880454 | Kelly E Wurzel | Psychiatry & Neurology | 624 E. Front Ave, Spokane, WA 99204 | 2012-04-11 |
| 1003190331 | Katie L Gomez | Nurse Practitioner | 805 W. 5th Ave, Suite 518, Spokane, WA 99204 | 2011-10-05 |
| Find all providers in zip 99204 | ||||
| Taxonomy Code | 224P00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Prosthetist |
| A health care professional who is specifically educated and trained to manage comprehensive prosthetic patient care for individuals who have sustained complete or partial limb loss or absence. Prosthetists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427243468 | Andrew J Lind | Prosthetist | 401 S Sherman St, Spokane, WA 99202-6001 | 2007-09-12 |
| 1821289059 | William L Kidd | Prosthetist | 124 E Pacific Ave, Spokane, WA 99202-1518 | 2007-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043785777 | Natalie Kirsten Harold | Prosthetist | 123 2nd Ave S Ste 200, Edmonds, WA 98020-8449 | 2018-10-09 |
| 1497129092 | Stevie Stephens | Prosthetist | 723 Mlk Jr Way, Tacoma, WA 98405 | 2015-11-19 |
| 1508057845 | David M Kelly | Prosthetist | 1900 116th Ave Ne Ste 201, Bellevue, WA 98004-3013 | 2007-08-01 |
| 1093891616 | Virginias Feminine Boutique, LLC | Prosthetist | 3627 152nd St Ne, Marysville, WA 98271-8944 | 2006-10-27 |
| 1912081860 | American Artificial Limb Co | Prosthetist | 650 S Orcas St, Suite 100, Seattle, WA 98108-2654 | 2006-10-25 |
| 1487631586 | Michael Philip Podrasky | Prosthetist | 1420 4th St Se, Ste D, Puyallup, WA 98372 | 2005-12-29 |
| 1891394086 | Janae Christine Buchan | Prosthetist | 2621 Ne 134th St Ste 120, Vancouver, WA 98686-3036 | 2020-10-20 |
| 1164020426 | Sarah Mccarthy Cheever | Prosthetist | 4575 Sand Point Way Ne, Seattle, WA 98105-3950 | 2020-10-09 |
| 1720612450 | Sean C Hails | Prosthetist | 1901 S Cedar St Ste 202, Tacoma, WA 98405-2303 | 2020-03-03 |
| 1205469889 | Shannon J Kim | Prosthetist | 10740 Meridian Ave N Ste G2, Seattle, WA 98133-9010 | 2020-02-21 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.