Individual
ROBERT ALLEN WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4585 SW 185TH AVE, ALOHA, OR 97078-1557
(503) 591-9280
(503) 640-0387
Mailing address
4585 SW 185TH AVE, ALOHA, OR 97078-1557
(503) 591-9280
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/24/2024
Last updated
07/24/2024
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