COREY WAGNER

PORTLAND, OR
NPI1861203036
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR  25-CRM-4021)
Enumeration Date2025-01-16
Last Update Date2025-01-16
Business Address
COREY WAGNER
1817 NE 6TH AVE
PORTLAND, OR 97212-3960
Phone number: 503-719-7985
Mailing Address
COREY WAGNER
1817 NE 6TH AVE
PORTLAND, OR 97212-3960
Phone number:
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