Individual
AMELIE M WEGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
110 CENTER AVE, MOLALLA, OR 97038-8134
(503) 829-1400
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD194762
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
NM
Other
Enumeration date
08/14/2013
Last updated
10/19/2020
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