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1346608452
STEPHANIE R WAGONER
SEATTLE, WA
NPI
1346608452
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
133V00000X Dietitian, Registered
(Licence: WA 1039941)
Enumeration Date
2016-02-03
Last Update Date
2016-02-03
Business Address
-- STEPHANIE R WAGONER RD
5505 27TH AVE NE APT 2
SEATTLE, WA 98105-5540
Phone number: 360-609-2555
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Mailing Address
-- STEPHANIE R WAGONER RD
5505 27TH AVE NE APT 2
SEATTLE, WA 98105-5540
Phone number: 360-609-2555
Copy
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