Individual
SARA WEGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3900 PACIFIC AVE, FOREST GROVE, OR 97116-2226
(503) 359-0449
Mailing address
25117 SW PARKWAY AVE STE D, WILSONVILLE, OR 97070-9697
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
09240
OR
225200000X
Physical Therapy Assistant
A1956
MN
Other
Enumeration date
09/10/2015
Last updated
09/11/2015
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