Individual
ESTRELLITA WAGNER- VILLASENOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
21413 111TH CT SE, KENT, WA 98031-2190
(206) 225-0747
Mailing address
21413 111TH CT SE, KENT, WA 98031-2190
(206) 225-0747
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA60708335
WA
Other
Enumeration date
03/03/2017
Last updated
03/03/2017
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