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1023552114
JEFFREY DAVID WAGNER
PORTLAND, OR
NPI
1023552114
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: OR 201801605NP-PP)
Enumeration Date
2016-12-08
Last Update Date
2018-09-07
Business Address
Dr. JEFFREY DAVID WAGNER DNP, ARNP
3303 SW BOND AVE
PORTLAND, OR 97239
Phone number: 503-418-9400
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Mailing Address
Dr. JEFFREY DAVID WAGNER DNP, ARNP
3303 SW BOND AVE
PORTLAND, OR 97239-4501
Phone number: 503-418-9400
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