Individual
MR. SCOTT EDWARD WAGNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2830 CRESCENT AVE, EUGENE, OR 97408-7397
(541) 686-9000
(541) 242-4585
Mailing address
1655 S. ELM ST. #207, CANBY, OR 97013-3960
(503) 260-5433
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA01088
OR
Other
Enumeration date
09/13/2006
Last updated
02/01/2015
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