Provider Demographics
NPI:1619487113
Name:MAGANA, WENDY N (ARNP)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:N
Last Name:MAGANA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5205 S 2ND AVE STE G&H
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98203-4114
Mailing Address - Country:US
Mailing Address - Phone:425-842-2324
Mailing Address - Fax:425-845-0096
Practice Address - Street 1:5205 S 2ND AVE STE G&H
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98203-4114
Practice Address - Country:US
Practice Address - Phone:425-842-2324
Practice Address - Fax:425-845-0096
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-10
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60784896363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily