Individual
DR. RACHEL M WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2220 CORNWALL AVE, BELLINGHAM, WA 98225-3719
(360) 752-2865
(360) 647-8093
Mailing address
873 HINOTES CT, SUITE 1, LYNDEN, WA 98264-9043
(360) 318-9705
(360) 318-8735
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00045321
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0201489
LABOR & INDUSTRIES (REG)
WA
01
—
3970WA
REGENCE BLUESHIELD
WA
05
—
8436636
—
WA
01
—
8926939
LABOR & INDUSTRIES (CV)
WA
Enumeration date
06/03/2006
Last updated
07/08/2007
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