Wagner, Alyssa Rose

Wagner, Alyssa Rose is an individual health care provider with primary practice located at 353 Deadmond Ferry Rd , Springfield OR 97477-9406. She recently has only one registered license in Nursing Service Providers / Lactation Consultant, which is considered as her primary health care specialty. Wagner, Alyssa Rose can be contacted via phone (541) 337-4970.

Contact Information

Primary practice address
353 Deadmond Ferry Rd Springfield OR 97477-9406
Phone: (541) 337-4970
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Lactation Consultant 163WL0100X 201140420RN Oregon

Profile Details

NPI number 1700352143
LBN Legal business name Wagner, Alyssa Rose
Credentials IBCLC
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 23rd, 2018
Last updated Oct 23rd, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700352143 NPPES
Oregon Other L-144285 IBLCE

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