Individual
MARINA ALYSSA WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
12442 SW SCHOLLS FERRY RD STE 206, TIGARD, OR 97223-0804
(503) 216-9200
Mailing address
12442 SW SCHOLLS FERRY RD STE 206, TIGARD, OR 97223-0804
(503) 216-9200
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO218072
OR
Other
Enumeration date
03/27/2021
Last updated
01/21/2026
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