-- FREDRICK CHARLES WAGNER -- MD
Individual Provider (NPI-1)
Active
Provider Information
- NPI Number
1609869635- Provider Type
- Individual Provider (NPI-1)
- Credentials
- MD
- Status
- Active
Contact & Location
- Address
- 9205 SW BARNES RD, PORTLAND, OR, 972256603
- Phone
- (503) 216-2195
- Fax
- (503) 216-2196
Specialties & Taxonomies
Unknown
Primary License: OR #MD09972