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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1649211764 | NPPES |
| Washington | Other | 378219 | LABOR AND INDUSTRY |
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