Individual
MICHAEL WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1610 WOODS CT, HOOD RIVER, OR 97031-2911
(541) 386-2620
Mailing address
412 E SCENIC DR, THE DALLES, OR 97058-3434
(509) 261-0620
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/13/2015
Last updated
07/14/2016
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