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Contact Information

JEFFREY D WAGNER, DNP, ARNP
3303 SW BOND AVE
PORTLAND, OR97239
 Phone: 503-418-9400
 Fax: 503-418-9401
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for JEFFREY D WAGNER · (Male)

NPI Number 1023552114
Status Active
Credentials DNP, ARNP
Entity Individual
Enumeration date 12/08/2016
Last updated 09/07/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • OR License # 201801605NP-PP
Hospital affiliation(s)
  • OHSU HOSPITAL AND CLINICS - (Acute Care)
    3181 SW SAM JACKSON PARK ROAD
    PORTLAND, OR 97239
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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