Individual
JILL FRANCENE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
12040 NE 128TH ST # MS -103, KIRKLAND, WA 98034-3013
(425) 531-4615
Mailing address
27818 NE 141ST ST, DUVALL, WA 98019-6307
(206) 650-5675
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
00004042
WA
Other
Enumeration date
01/16/2024
Last updated
01/16/2024
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