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1992161491
AUDREY WAGNER
PORTLAND, OR
NPI
1992161491
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1835P2201X Pharmacist, Ambulatory Care
(Licence: OR RPH0013676)
Enumeration Date
2016-01-13
Last Update Date
2016-01-13
Business Address
-- AUDREY WAGNER
727 W BURNSIDE ST
PORTLAND, OR 97209-3514
Phone number: 503-228-4533
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Mailing Address
-- AUDREY WAGNER
232 NW 6TH AVE
PORTLAND, OR 97209-3609
Phone number: 503-294-1681
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