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General NPI Number Information
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NPI Number | 1346098548
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Entity Type | Individual
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Provider Name | RACHEL L. WAGNER ARNP
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Gender | Female
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Dates
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Enumeration Date | 05/11/2024
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Last Update Date | 12/12/2024
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Provider Practice Location Address
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Address Line | 945 GOETHALS DR STE 200
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City | RICHLAND
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State | WA
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Zip | 99352-3552
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Country | US
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Telephone | 509-942-2555
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Fax | 509-942-2340
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Provider Business Mailing Address
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Address Line | 550 GAGE BLVD STE 101
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City | RICHLAND
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State | WA
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Zip | 99352-9532
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Country | US
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Telephone | 509-473-0637
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Fax | 509-627-2983
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | C-APN.0102184-C-NP
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | AP61620319
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP61620319
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 0001288759
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License Number State | VA
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