MEDICARE: DR. MARY K. WAGNER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	MD60167561	WA

General Provider Information

NPI Number	:	1427040203
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARY K. WAGNER M.D.

Provider Business Mailing Address
First Line	:	1414 N VERCLER RD
Second Line	:	BUILDING 1
City	:	SPOKANE VALLEY
State	:	WA
Zip	:	99216-1092
Country	:	US
Telephone Number	:	509-928-6383
Fax Number	:	509-926-9420

Provider Business Practice Location Address
First Line	:	1414 N VERCLER RD
Second Line	:	BUILDING 1
City	:	SPOKANE VALLEY
State	:	WA
Zip	:	99216-1092
Country	:	US
Telephone Number	:	509-928-6383
Fax Number	:	509-926-9420

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/18/2005
Last Update Date	:	07/29/2011

Similar Medicare Providers

1225073588 — VALLEY ASSOCIATED UROLOGY MEDICARE GROUP INC
Practice Location Address:

200 COTTAGE AVE , STE 101
MANTECA, CA
95336-4935

Practice Phone: 209-239-2197
Practice Fax: 209-239-7672

1104785583 — GINA HENDRICK
Practice Location Address:

1414 N VERCLER RD STE 2
SPOKANE VALLEY, WA
99216-1092

Practice Phone: 509-991-7885
Practice Fax:

1033078126 — SIERRA CUARISMA
Practice Location Address:

1414 N VERCLER RD STE 2
SPOKANE VALLEY, WA
99216-1092

Practice Phone: 509-991-7885
Practice Fax:

1568459816 — MR. LAINE DEAN HUGHES NP
Practice Location Address:

1414 N VERCLER RD STE 1
SPOKANE VALLEY, WA
99216-1092

Practice Phone: 509-928-6383
Practice Fax:

1043243108 — DR. MARC WEIAND D.D.S.
Practice Location Address:

1414 N VERCLER RD , #6
SPOKANE VALLEY, WA
99216-1092

Practice Phone: 509-926-1589
Practice Fax: 509-892-5168

1922024496 — DR. RON W. WEIAND D.D.S.
Practice Location Address:

1414 N VERCLER RD , #6
SPOKANE VALLEY, WA
99216-1092

Practice Phone: 509-926-1589
Practice Fax: 509-892-5168

Directions to “ DR. MARY K. WAGNER M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.