Individual
MARY ANN WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4545 CORDATA PKWY STE LL4, BELLINGHAM, WA 98226-7263
(360) 752-5622
(360) 752-5624
Mailing address
9414 NE FOURTH PLAIN BLVD, VANCOUVER, WA 98662-6109
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT61027876
WA
225XP0200X
Pediatric Occupational Therapist
61027876
WA
Other
Enumeration date
02/10/2020
Last updated
09/15/2024
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