Individual
CHRISTOPHER WILLIAM WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9040 JACKSON AVENUE, TACOMA, WA 98431-0001
(253) 968-1250
Mailing address
9040 JACKSON AVENUE, TACOMA, WA 98431-0001
(253) 968-1250
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
—
—
208D00000X
General Practice Physician
Primary
0101280169
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/01/2022
Last updated
10/12/2023
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