Individual
MRS. KELLY ANNE WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
7500 212TH ST SW STE 204, EDMONDS, WA 98026-7617
(360) 504-8893
Mailing address
7500 212TH ST SW STE 204, EDMONDS, WA 98026-7617
(360) 504-8893
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
61092065
WA
Other
Enumeration date
08/13/2013
Last updated
06/11/2025
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