Individual
JESSICA WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
200 N MONROE ST, EUGENE, OR 97402-4243
(541) 790-7638
Mailing address
950 E 23RD AVE, EUGENE, OR 97405-3075
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
016454
OR
Other
Enumeration date
04/25/2024
Last updated
04/25/2024
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