KAI JONATHAN WAGNER

SPOKANE VALLEY, WA
NPI1063165587
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101Y00000X Counselor
(Licence: WA  CG61270605)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2022-02-03
Last Update Date2022-10-14
Business Address
KAI JONATHAN WAGNER
317 N PINES RD
SPOKANE VALLEY, WA 99206-5120
Phone number: 509-838-4651
Mailing Address
KAI JONATHAN WAGNER
107 S DIVISION ST
SPOKANE, WA 99202-1510
Phone number: 509-838-4651