Individual
ANDREA M WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
180 ATWATER ST N, MONMOUTH, OR 97361-1801
(503) 606-3288
(503) 606-3287
Mailing address
320 SE BAKER ST, MCMINNVILLE, OR 97128-6038
(503) 474-3600
(503) 474-3601
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
200950140NP
OR
Other
Enumeration date
12/23/2009
Last updated
08/12/2020
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