Individual
MS. LEANN WAGGONER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSWA
Contact information
Practice address
3710 SW US VETERANS HOSPITAL RD, PORTLAND, OR 97239-2999
(503) 220-8262
Mailing address
3710 SW US VETERANS HOSPITAL RD, PORTLAND, OR 97239-2999
(503) 220-8262
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
A4602
OR
Other
Enumeration date
10/19/2020
Last updated
10/19/2020
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