Organization
WAGAMAN ENTERPRISES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY DANIEL WAGAMAN PH.D. (OWNER/ PRESIDENT)
(360) 866-7406
Entity
Organization
Contact information
Practice address
2100 CATON WAY SW, OLYMPIA, WA 98502-1105
(360) 866-7406
(360) 570-3325
Mailing address
2100 CATON WAY SW, OLYMPIA, WA 98502-1105
(360) 866-7406
(360) 570-3325
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY 1722
WA
Other
Enumeration date
11/16/2007
Last updated
01/25/2010
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