Individual
BRADY WAYNE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2875 NE STUCKI AVE, HILLSBORO, OR 97124-5806
(800) 813-2000
Mailing address
500 NE MULTNOMAH ST STE 100, PORTLAND, OR 97232-2031
(800) 813-2000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD159208
OR
207P00000X
Emergency Medicine Physician
MD60292835
WA
Other
Enumeration date
05/19/2009
Last updated
03/19/2026
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