Individual
KRISTIN JO WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3919 N MAPLE ST, SPOKANE, WA 99205-1349
(509) 444-8888
(509) 444-7810
Mailing address
35925 N PIKE RD, DEER PARK, WA 99006-9147
(509) 292-8398
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH00020076
WA
Other
Enumeration date
11/20/2006
Last updated
07/08/2007
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