Individual
VICKI LYNN WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
502 4TH ST NE, AUBURN, WA 98002-5020
(253) 931-4990
Mailing address
502 4TH ST NE, AUBURN, WA 98002-5020
(253) 931-4990
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
RN00077448
WA
Other
Enumeration date
10/30/2018
Last updated
10/30/2018
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