Individual
KAJA WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
OREGON STATE HOSPITAL 2600 CENTER ST NE, PHARMACY DEPARTMENT, SALEM, OR 97301
(425) 221-0947
(503) 947-1085
Mailing address
OREGON STATE HOSPITAL 2600 CENTER ST NE, PHARMACY DEPARTMENT, SALEM, OR 97301
(425) 221-0947
(503) 947-1085
Taxonomy
Speciality
Code
Description
License number
State
1835P1300X
Psychiatric Pharmacist
Primary
RPH-0015583
OR
Other
Enumeration date
09/21/2016
Last updated
09/21/2016
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