IndividualActive
Mark Wagner, M.D.
NPI 1649211764 · Sports Medicine (Family Medicine) Physician · Seattle, WA
Provider details
- NPI number
- 1649211764
- Entity type
- Individual
- Primary specialty
- Sports Medicine (Family Medicine) PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- License
- MD00022633 (WA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
1000 Dexter Ave N Ste 320
Seattle, WA 98109-4878
Phone: (206) 620-0333
Fax: (206) 462-7520
Approximate (ZIP-level) locationGet directions
Mailing address
1000 Dexter Ave N Ste 320
Seattle, WA 98109-4878
Additional practice locations (1)
- 1000 Dexter Ave N Ste 320Seattle, WA 98109-4878Phone: (206) 620-0333Fax: (206) 462-7520
Registry dates
- Enumerated
- 2006-06-09
- Last updated
- 2019-05-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.