Zackery Robert Wagner

NPI #1720774177 in Enumclaw, Washington

Provider Information

NPI Number: 1720774177
Entity Type: Individual
Name: Zackery Robert Wagner
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Nurse's Aide
Enumeration Date: Apr 17, 2023
Last Updated: Apr 17, 2023

Practice Location

Address: 2323 JENSEN ST
City: Enumclaw
State: Washington
ZIP Code: 98022-3605
Phone: (360) 825-2541

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Nurse's Aide	376K00000X	Primary

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