Individual
MICHAEL SCOTT WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
16708 BOTHELL EVERETT HWY STE 103, MILL CREEK, WA 98012-6345
(425) 481-4440
Mailing address
16708 BOTHELL EVERETT HWY STE 103, MILL CREEK, WA 98012-6345
(425) 481-4440
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD61308446
WA
Other
Enumeration date
06/03/2022
Last updated
06/03/2022
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