MS. SARAH C WAGNER (NPI# 1720174931) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720174931 |
| Entity Type | Individual |
| Full Name | MS. SARAH C WAGNER |
| Credential | PA-C |
| Practice Address |
9290 Se Sunnybrook Blvd Suite 120 Clackamas OR 97015-6802 |
| Mailing Address |
Po Box 3158 Portland OR 97208-3158 |
| Practice Telephone | 5032152110 |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2015-02-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA161499 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | 3110 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | 99 | MT | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | RAILROAD MEDICARE - PH&S | R01271179 | 01 |
| OR | 500657211 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235557133 | Sarah Wagner | Occupational Therapist | 840 Benmosche Rd., Harris, NY 12742 | 2014-03-29 |
| 1588081707 | Sarah Wagner | Social Worker | 51 E 3rd St, Dunkirk, NY 14048-2201 | 2014-03-26 |
| 1922435668 | Sarah J Wagner | Counselor | 371 North Main Street, Second Floor, Butler, PA 16001 | 2013-09-26 |
| 1659986859 | Sarah Wagner | Behavior Technician | 6475 Sierra Ln, Dublin, CA 94568-2796 | 2020-09-14 |
| 1700442738 | Sarah L Wagner | Physician Assistant | 421 Chestnut St, Evansville, IN 47713-1227 | 2019-05-15 |
| 1083187165 | Sarah Ruth Wagner | Nurse Practitioner | 3801 Miranda Ave, Palo Alto, CA 94304-1207 | 2019-01-10 |
| 1679044283 | Sarah N Wagner | Licensed Practical Nurse | 454 Broadway, Revere, MA 02151-3034 | 2018-12-07 |
| 1891279360 | Sarah Wagner | Physical Therapist | 1377 11th St Nw, Clinton, IA 52732-5068 | 2018-09-20 |
| 1356841910 | Sarah Wagner | Nurse Practitioner | 8345 Wicker Ave, Saint John, IN 46373-8879 | 2018-02-20 |
| 1528580214 | Sarah Wagner | Physical Therapist | 121 Boatyard Dr, Fort Bragg, CA 95437-5751 | 2017-07-13 |
| Street Address |
9290 SE SUNNYBROOK BLVD SUITE 120 |
| City | CLACKAMAS |
| State | OR |
| Zip Code | 97015-6802 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639163447 | Randall D Gore | Internal Medicine | 9290 Se Sunnybrook Blvd, Suite 120, Clackamas, OR 97015-6899 | 2005-09-07 |
| 1134660558 | Kelcey Chilcott | Nurse Practitioner | 9290 Se Sunnybrook Blvd, 200, Clackamas, OR 97015-6899 | 2017-03-17 |
| 1922451103 | Mackenna Marie Simpson | Physician Assistant | 9290 Se Sunnybrook Blvd, #120, Clackamas, OR 97015-6899 | 2016-07-22 |
| 1669844809 | Mary Steers | Psychologist | 9290 Se Sunnybrook Blvd, Ste 120, Clackamas, OR 97015-6899 | 2015-10-27 |
| 1952771008 | Danielle Marie Hastings | Nurse Practitioner | 9290 Se Sunnybrook Blvd, #200, Clackamas, OR 97015-6899 | 2015-10-01 |
| 1225422165 | Olivia Marie Gordon | Counselor | 9290 Se Sunnybrook Blvd, Suite 200, Clackamas, OR 97015-6899 | 2015-03-27 |
| 1053716621 | Michelle Shepherd Combs | Psychologist | 9290 Se Sunnybrook Blvd, Clackamas, OR 97015-6899 | 2014-10-24 |
| 1609298967 | Providence Health & Services - Oregon | Clinic/Center | 9290 Se Sunnybrook Blvd, Suite 120, Clackamas, OR 97015-6802 | 2014-01-06 |
| 1790107050 | Providence Health & Services - Oregon | Clinic/Center | 9290 Se Sunnybrook Blvd, Suite 120, Clackamas, OR 97015-6802 | 2014-01-06 |
| 1730529629 | Jennifer Joan Beemer | Nurse Practitioner | 9290 Se Sunnybrook Blvd, Suite 120, Clackamas, OR 97015-6802 | 2013-06-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184103517 | Laurel Perilli | Physical Therapist | 12550 Se 93rd Ave Ste 265, Clackamas, OR 97015 | 2018-08-07 |
| 1306324538 | Kristin Connor Messing | Physical Therapist | 4805 Ne Glisan St, Prov Hall 7e06, Portland, OR 97015 | 2018-07-31 |
| 1902317266 | Darcy Jones Hamrick | Counselor | 12901 Se 97th Ave., Suite 340, Clackamas, OR 97015 | 2017-10-13 |
| 1841723384 | Manon Lavoie | Chiropractor | 17105 Se Sunnyside Rd, Suite 148, Happy Valley, OR 97015 | 2017-04-11 |
| 1235670126 | Michael G Short | Pedorthist | 10117 Se Sunnyside Rd., Ste. H, Clackamas, OR 97015 | 2017-03-13 |
| 1487100756 | Michael Joseph Peizner | Pharmacist | 16300se Evelyn Street, Clackamas, OR 97015 | 2016-08-28 |
| 1316395619 | Jennifer Elaine Walkowski | Physical Therapist | 9100 Se Sunnyside Road, Clackamas, OR 97015 | 2016-05-26 |
| 1649635384 | Brookside Dental - Milwaukie, LLC | Dentist | 9225 Se Sunnyside Rd. Ste 1, Clackamas, OR 97015 | 2015-12-23 |
| 1801216130 | Robert D. Grew Dmd, Inc. | Dentist | 10163 Se Sunnyside Road, Suite 414, Clackamas, OR 97015 | 2014-04-25 |
| 1508205410 | Valerie P Tabalno | Massage Therapist | 15661 Se 82nd Dr, Clackamas, OR 97015 | 2013-06-25 |
| Find all providers in zip 97015 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558645812 | Jenna Smith | Physician Assistant | 9290 Se Sunnybrook Blvd Ste 120, Clackamas, OR 97015-6802 | 2011-10-05 |
| 1821183229 | Frank John Pacosa | Physician Assistant | 9800 Sunnyside Rd., Clackamas, OR 97015 | 2006-10-03 |
| 1306930722 | Todd Joseph Van Hee | Physician Assistant | Kaiser Permanente Mt Scott Medical Office, 9800 Se Sunnyside Rd, Clackamas, OR 97015-9750 | 2006-10-02 |
| 1710943402 | Billy L. Cunnington | Physician Assistant | 10330 Se 32nd Avenue, Suite 210, Clackamas, OR 97222-6594 | 2006-04-22 |
| 1225686611 | Brittney Nichole Nelson | Physician Assistant | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2019-08-28 |
| 1831674985 | German Collazo | Physician Assistant | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2018-09-25 |
| 1437671617 | Amber Marie Morrison | Physician Assistant | 9800 Se Sunnyside Rd, Clackamas, OR 97015-9750 | 2017-07-10 |
| 1922451103 | Mackenna Marie Simpson | Physician Assistant | 9290 Se Sunnybrook Blvd, #120, Clackamas, OR 97015-6899 | 2016-07-22 |
| 1235594896 | Celeste Richardson | Physician Assistant | 9900 Se Sunnyside Rd, Kaiser Permanente Sunnybrook Medical Office, Clackamas, OR 97015-9777 | 2015-12-28 |
| 1629408794 | Samantha Ann Stevenson-stowell | Physician Assistant | 9290 Se Sunnybrook Blvd Ste 120, Clackamas, OR 97015 | 2013-11-26 |
| Find all providers in CLACKAMAS | ||||
Please comment or provide details below to improve the information on MS. SARAH C WAGNER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.