Individual
ELIZABETH WANGLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CG 61223446
Contact information
Practice address
124 S 3RD ST, YAKIMA, WA 98901-2828
(509) 571-4288
Mailing address
PO BOX 2849, YAKIMA, WA 98907-2849
(509) 571-4288
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
61223446
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
91-0755984
—
WA
Enumeration date
02/16/2022
Last updated
02/16/2022
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