Individual
CLIFFORD WILLIAM WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9120 NE VANCOUVER MALL LOOP, SUITE 230, VANCOUVER, WA 98662-6353
(360) 896-9393
(360) 896-0878
Mailing address
9120 NE VANCOUVER MALL LOOP, SUITE 230, VANCOUVER, WA 98662-6353
(360) 896-9393
(360) 896-0878
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00032505
WA
Other
Enumeration date
04/30/2010
Last updated
04/30/2010
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