Individual
WENDY SUE-ELLEN WARREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE, TACOMA, WA 98431-5051
(253) 968-1110
Mailing address
115 PURPLE HEART AVE, DOVER AFB, DE 19902-5051
(302) 346-8678
Taxonomy
Speciality
Code
Description
License number
State
207ZF0201X
Forensic Pathology Physician
796
NE
207ZF0201X
Forensic Pathology Physician
Primary
H0086517
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
796
OSTEOPATHIC PHYSICIAN & SURGEON LICENSE
NE
01
—
H0086517
PHYSICIAN AND SURGEON LICENSE
MD
Enumeration date
07/06/2009
Last updated
11/15/2019
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