Individual
DR. STEPHEN C WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
5802 SE POWELL BLVD, PORTLAND, OR 97206-2826
(503) 774-3778
(503) 774-3880
Mailing address
5802 SE POWELL BLVD, PORTLAND, OR 97206-2826
(503) 774-3778
(503) 774-3880
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3929
OR
Other
Enumeration date
09/11/2009
Last updated
09/11/2009
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