Wagner, Andrew
Wagner, Andrew is an individual health care provider with primary practice located at 24076 Se Stark St Ste 200 , Gresham OR 97030-3376. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Hand. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Hand is his primary health care specialty. Wagner, Andrew can be contacted via phone (503) 674-7860.Contact Information
Primary practice address
24076 Se Stark St Ste 200
Gresham OR 97030-3376
Phone: (503) 674-7860
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Social Worker | 104100000X | Oregon | |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Hand | 225XH1200X | 423249 | Oregon |
Profile Details
NPI number | 1073900320 |
---|---|
LBN Legal business name | Wagner, Andrew |
Credentials | |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Apr 23rd, 2015 |
Last updated | Nov 29th, 2022 - about 2 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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