Provider Demographics
NPI:1356899363
Name:WAGLER, EMILY (DPM)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:WAGLER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2622 YALE AVE E
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98102-3229
Mailing Address - Country:US
Mailing Address - Phone:206-795-0656
Mailing Address - Fax:
Practice Address - Street 1:34509 9TH AVE S STE 303
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-8709
Practice Address - Country:US
Practice Address - Phone:253-942-2280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-19
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0116030817213ES0103X
WAPODI.PO.61051050213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery