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1366860009
KATHRYN WAGNER
PORTLAND, OR
NPI
1366860009
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207T00000X Neurological Surgery
(Licence: TX 582526)
Enumeration Date
2014-03-31
Last Update Date
2021-12-07
Business Address
KATHRYN WAGNER MD
3101 SW 13TH AVE APT 19
PORTLAND, OR 97239-3071
Phone number: 503-550-2870
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Mailing Address
KATHRYN WAGNER MD
2900 STATE ST
MEDFORD, OR 97504-8458
Phone number: 541-779-1672
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