Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Maxwell Wilson

Individual provider Occupational Therapist · NPI 1417819848

Maxwell Wilson is an Occupational Therapist in Private Practice in Longview, Washington. Qualified in 2024, 2 years ago. Licensed in Washington.

Years since qualifying
2
Licensed in
WA
In the registry since
2025
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Practice location Address checks out

200 Triangle Ctr #270
Longview, WA 98632-2367
Phone: (360) 501-3750
Fax: (360) 501-3755
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence 61642856 (WA)

Record details

NPI number1417819848
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedNovember 24, 2025
Last updated in NPPESJanuary 23, 2026
Certification dateJanuary 23, 2026
Mailing address1615 Delaware St, Longview, WA 98632-2367

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOCCUPATIONAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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