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Individual

DR. L. DOUGLAS WAGGONER JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
122 W 7TH AVE, SUITE 310, SPOKANE, WA 99204-2349
(509) 838-7711
(509) 747-4664
Mailing address
122 W 7TH AVE, SUITE 310, SPOKANE, WA 99204-2349
(509) 838-7711
(509) 747-4664

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
MD37590
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
806556100
ID
Enumeration date
05/19/2006
Last updated
01/18/2017
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