Individual
CODY KEITH WASNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1007 HARLOW RD STE 210, SPRINGFIELD, OR 97477-7126
(541) 741-0387
(541) 242-4634
Mailing address
PO BOX 1648, EUGENE, OR 97440-1648
(541) 242-4384
(541) 463-2820
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
12537
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
228395
—
OR
Enumeration date
08/16/2005
Last updated
10/23/2025
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