Individual
JENNIFER A WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN00154307
Contact information
Practice address
4304 W CHESTNUT AVE, YAKIMA, WA 98908-3257
(509) 823-4200
(509) 823-4220
Mailing address
4304 W CHESTNUT AVE, YAKIMA, WA 98908-3257
(509) 823-4200
(509) 823-4220
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN00154307
WA
Other
Enumeration date
11/14/2018
Last updated
11/14/2018
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