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NPI Profile for LESA WAGNER in NEWPORT, OR.
General classification identifying individuals who are trained on a specific piece of equipment or technical procedure.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Specialist/Technologist |
225500000X |
| NPI Number | 1447827407 |
|
| Status | Active | |
| Credentials | MTD | |
| Entity | Individual | |
| Enumeration date | 06/08/2021 | |
| Last updated | 06/08/2021 - About 5 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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LESA WAGNER
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LESA WAGNER, MTD