IndividualActive
Andrew Wagner
NPI 1073900320 · Hand Occupational Therapist · Gresham, OR
Provider details
- NPI number
- 1073900320
- Entity type
- Individual
- Primary specialty
- Hand Occupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
- Social Worker104100000X
Behavioral Health & Social Service Providers
Practice location
24076 Se Stark St Ste 200
Gresham, OR 97030-3376
Phone: (503) 674-7860
Approximate (ZIP-level) locationGet directions
Mailing address
24076 Se Stark St Ste 200
Gresham, OR 97030-3376
Registry dates
- Enumerated
- 2015-04-23
- Last updated
- 2022-11-29
- Certified
- 2022-11-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.