Search › Washington › 111N00000X
Blake Wagner, D.C
NPI 1134267735 · on the registry since 2007 · sole proprietor
Practice
- Address
- 21505 Market Pl Nw
Suite 102
Poulsbo, WA 98370 - Phone
- (360) 598-3143
- Fax
- (360) 598-4172
- Organisation at this address
- Wagner Family Wellness Center Llc
Inferred from a shared address, not stated in the registry.
Registry record
- Primary taxonomy
- 111N00000X
111N00000X
- Licence states on file
- WA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2011-04-25
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Washington