Active NPI
William Shane Wilson
- Licensed Practical Nurse
- Vancouver, WA
National Provider Identifier
1801705207
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- LP00046353
- Practice address
- 2805 E 19TH St
Vancouver, WA 98661-4614 - Phone
- (360) 255-5993
- Fax
- (360) 768-5992
- NPI assigned
- Sep 2, 2026
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | LP00046353 | WA | Primary |
Addresses
Primary practice location
2805 E 19TH St
Vancouver, WA 98661-4614
Mailing address
2805 E 19TH St
Vancouver, WA 98661-4614
Phone (360) 255-5993
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1788307200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788307200000",
"number": "1801705207",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2805 E 19TH ST",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986614614",
"telephone_number": "360-255-5993",
"fax_number": "360-768-5992"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2805 E 19TH ST",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986614614",
"telephone_number": "360-255-5993",
"fax_number": "360-768-5992"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "WILLIAM",
"middle_name": "SHANE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-09-02",
"last_updated": "2026-09-02",
"certification_date": "2026-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Licensed Practical Nurse",
"state": "WA",
"license": "LP00046353",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.