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1417692351
CHRISTIAN MICAIAH WAGNER
WILSONVILLE, OR
NPI
1417692351
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
Enumeration Date
2022-05-04
Last Update Date
2022-05-04
Business Address
CHRISTIAN MICAIAH WAGNER
29100 SW TOWN CENTER LOOP W STE 190
WILSONVILLE, OR 97070-9317
Phone number: 503-443-6156
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Mailing Address
CHRISTIAN MICAIAH WAGNER
16083 SW UPPER BOONES FERRY RD STE 300
PORTLAND, OR 97224-7736
Phone number: 503-443-6156
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