MATTHEW DALE WAGNER

PORTLAND, OR
NPI1487869996
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy208800000X Urology
(Licence: OR  LL16353)
Enumeration Date2007-05-10
Last Update Date2007-07-08
Business Address
Dr. MATTHEW DALE WAGNER M.D.
3303 SW BOND AVE CH10U
PORTLAND, OR 97239-4501
Phone number: 503-494-8311
Mailing Address
Dr. MATTHEW DALE WAGNER M.D.
1836 SE 36TH AVE
PORTLAND, OR 97214-5128
Phone number: 503-525-5833
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