STEPHANIE NICOLE WAGNER

PORTLAND, OR
NPI1902493240
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR  T-20-431)
Enumeration Date2020-12-21
Last Update Date2020-12-21
Business Address
STEPHANIE NICOLE WAGNER
2600 SE BELMONT ST
PORTLAND, OR 97214-2916
Phone number: 503-239-5738
Mailing Address
STEPHANIE NICOLE WAGNER
2600 SE BELMONT ST
PORTLAND, OR 97214-2916
Phone number: 503-239-5738
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