Individual
JEREMY WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
990 S HIGHWAY 395, HERMISTON, OR 97838-2623
(541) 564-1285
Mailing address
990 S HIGHWAY 395, HERMISTON, OR 97838-2623
(541) 564-1285
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0017103
OR
Other
Enumeration date
05/21/2019
Last updated
05/21/2019
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