Individual
ADAM RICHARD WAGGONER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
200 UNIVERSITY PKWY, YAKIMA, WA 98901-9539
(509) 452-5100
Mailing address
1016 TACOMA AVE, SUNNYSIDE, WA 98944-2263
(509) 837-1500
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
OP60840174
WA
Other
Enumeration date
06/07/2012
Last updated
04/13/2022
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