Individual
DR. ABE CHARLES BAGNIEWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
165 LILLY RD NE, OLYMPIA, WA 98506-5086
(360) 438-9092
Mailing address
165 LILLY RD NE STE A, OLYMPIA, WA 98506-5086
(360) 438-9092
(360) 438-3906
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
PO00000775
WA
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PO00000775
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0204603
STATE L&I
WA
05
—
1001166
—
WA
01
—
8940526
CRIME VICTIMS
WA
Enumeration date
07/30/2006
Last updated
06/30/2021
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