Individual
AMANDA WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
105 S 3RD ST, SAINT HELENS, OR 97051-2009
(503) 397-6900
(503) 397-5373
Mailing address
PO BOX 1234, SAINT HELENS, OR 97051-8234
(503) 397-5211
(503) 397-5373
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
OR
Other
Enumeration date
06/30/2016
Last updated
06/30/2016
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