Individual
JEFFREY WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
123 NW 36TH ST STE 210, SEATTLE, WA 98107-4959
(425) 640-7009
Mailing address
100 N HOWARD ST STE W, SPOKANE, WA 99201-0508
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LW70042194
WA
Other
Enumeration date
07/12/2023
Last updated
12/08/2025
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