AUDREY WAGNER (NPI# 1992161491) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992161491 |
| Entity Type | Individual |
| Full Name | AUDREY WAGNER |
| Practice Address |
727 W Burnside St Portland OR 97209-3514 |
| Mailing Address |
232 Nw 6th Ave Portland OR 97209-3609 |
| Practice Telephone | 5032284533 |
| Mailing Telephone | 5032941681 |
| Enumeration Date | 2016-01-13 |
| Last Update Date | 2016-01-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P2201X |
Pharmacist Specialization: Ambulatory Care |
RPH0013676 | OR | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841465002 | Audrey Karin Wagner | Emergency Medicine | 345 Saint Paul St, Mercy Medical Center, 9th Floor, Icu, Baltimore, MD 21202-2123 | 2008-04-28 |
| 1699876755 | Audrey Ruth Wagner | Physical Therapist | 2775 Schoenersville Rd, Bethlehem, PA 18017-7307 | 2006-09-25 |
| 1922047679 | Audrey Wagner | Psychologist | 173 Mount Auburn St, Watertown, MA 02472-4005 | 2006-06-06 |
| 1639127152 | Audrey Susan Wagner | Internal Medicine | 485 Arsenal St, Internal Medicine, Watertown, MA 02472-5091 | 2006-05-05 |
| Street Address |
727 W BURNSIDE ST |
| City | PORTLAND |
| State | OR |
| Zip Code | 97209-3514 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568410538 | David Nigel Adler IIi | Acupuncturist | 727 W Burnside St, Portland, OR 97209-3514 | 2006-05-04 |
| 1053973107 | Barbara Jean Cordova Ayala | Licensed Practical Nurse | 727 W Burnside St, Portland, OR 97209-3514 | 2019-06-28 |
| 1386200186 | Ronnie Lee Pickering | Student in an Organized Health Care Education/Training Program | 727 W Burnside St, Portland, OR 97209-3514 | 2019-05-16 |
| 1790254944 | Carissa Angela Marston | Physician Assistant | 727 W Burnside St, Portland, OR 97209-3514 | 2018-11-16 |
| 1518447119 | Amanda Nicole Cantu | Licensed Practical Nurse | 727 W Burnside St, Portland, OR 97209-3514 | 2018-08-14 |
| 1194204552 | Livian Marie Rand | Acupuncturist | 727 W Burnside St, Portland, OR 97209-3514 | 2018-08-07 |
| 1508366733 | Jason Sheffey | Peer Specialist | 727 W Burnside St, Portland, OR 97209-3514 | 2018-02-14 |
| 1528566445 | Mathew Reichardt | Counselor | 727 W Burnside St, Portland, OR 97209-3514 | 2018-01-25 |
| 1639681638 | Julie Cha Beert | Pharmacist | 727 W Burnside St, Portland, OR 97209-3514 | 2017-10-30 |
| 1821500117 | Kimberly Marie Hutchinson | Registered Nurse | 727 W Burnside St, Portland, OR 97209-3514 | 2017-10-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508476250 | Harrington Health Clinic | Nurse Practitioner | 310 Nw Glisan Street, Portland, OR 97209 | 2020-08-07 |
| 1619599636 | Rivers Way Training Clinic | Community/Behavioral Health | 2049 Nw Hoyt, Portland, OR 97209 | 2020-05-13 |
| 1518590538 | Julie Kay Igarta | Registered Nurse | 140 Northwest 14th Avenue, Portland, OR 97209 | 2020-02-18 |
| 1407492002 | Oregon Injection Clinic | Clinic/Center | 1500 Nw Lovejoy, 106, Portland, OR 97209 | 2019-11-19 |
| 1487202883 | Ann Tesora | Massage Therapist | 1320 Northwest 20th Avenue, Portland, OR 97209 | 2019-08-28 |
| 1972160455 | Vincent Martin | Massage Therapist | 210 Sw 17th Avenue, Portland, OR 97209 | 2019-05-21 |
| 1154896546 | Jennifer Marie Dodd | Social Worker | 1722 Nw Raleigh St Spc 412, Portland, OR 97209 | 2018-10-11 |
| 1922551910 | Ashley Crowell | Physician Assistant | 949 Nw Overton St Unit 306, Portland, OR 97209 | 2016-07-26 |
| 1326408394 | Jennifer Blain | Counselor | 324 Nw Davis, Portland, OR 97209 | 2016-03-03 |
| 1275993255 | Lauren Dodson | Licensed Practical Nurse | 324 Nw Davis St, Portland, OR 97209 | 2016-03-03 |
| Find all providers in zip 97209 | ||||
| Taxonomy Code | 1835P2201X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Ambulatory Care |
| A licensed pharmacist who has demonstrated specialized knowledge and skill in the provision of integrated, accessible health care services by pharmacists and is accountable for addressing medication needs, developing sustained partnerships with patients, and practicing in the context of family and community. |
| Notes: Source: Board of Pharmacy Specialties, www.bpsweb.org [7/1/2015: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265977086 | Robert Martini | Pharmacist | 18815 Ne Clackamas St, Portland, OR 97230-7138 | 2017-01-03 |
| 1477901643 | Shellie Weatherspoon | Pharmacist | 1040 Nw 22nd Ave Ste 100, Portland, OR 97210-3036 | 2016-05-29 |
| 1235757915 | Dustin J Clark | Pharmacist | 4400 Ne Halsey St Ste 490, Portland, OR 97213-1545 | 2020-07-09 |
| 1518585199 | Kasey Rubin | Pharmacist | 4400 Ne Halsey St Bldg 2, Portland, OR 97213-1545 | 2020-07-09 |
| 1194377960 | Anne M Thibodeaux | Pharmacist | 4400 Ne Halsey St, Portland, OR 97213-1545 | 2019-07-11 |
| 1720645872 | Kirsten Kadoyama | Pharmacist | 3600 N Interstate Ave, Portland, OR 97227 | 2019-05-23 |
| 1508422486 | Adam Rory Saulles | Pharmacist | 6348 Ne Halsey St, Portland, OR 97213-4720 | 2019-05-15 |
| 1295297018 | Victor Tran | Pharmacist | 1015 Nw 22nd Ave, Portland, OR 97210-3025 | 2019-04-01 |
| 1679058564 | Rita Maria Parsiani | Pharmacist | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2018-09-26 |
| 1598245151 | Kelsey Hawkins | Pharmacist | 5717 Ne 138th Ave, Portland, OR 97230-3409 | 2018-08-14 |
| Find all providers in PORTLAND | ||||
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| 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.