Wagner, Mark David

Wagner, Mark David is an individual health care provider with primary practice located at 1000 Dexter Ave N Ste 320 , Seattle WA 98109-4878. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Wagner, Mark David can be contacted via phone (206) 620-0333.

Contact Information

Primary practice address
1000 Dexter Ave N Ste 320 Seattle WA 98109-4878
Phone: (206) 620-0333
Fax: (206) 462-7520
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X MD00022633 Washington

Profile Details

NPI number 1649211764
LBN Legal business name Wagner, Mark David
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2006
Last updated May 7th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649211764 NPPES
Washington Other 378219 LABOR AND INDUSTRY

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