Individual
MARIE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1717 S J ST, TACOMA, WA 98405-4933
(253) 208-2804
Mailing address
9105 86TH AVE NW, GIG HARBOR, WA 98332-6770
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
61259389
WA
Other
Enumeration date
11/30/2023
Last updated
11/30/2023
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