Individual provider · Type 1 NPI

August Bruce Wagner

Professional Counselor · Portland, OR

NPI number 1447017082 Active

Practice location

333 SW Taylor St Ste 200
Portland, OR 97204-2446

Mailing address

17570 NW Cornell Rd Apt 7
Beaverton, OR 97006-8641

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500XR8260 (OR)

Professional Counselor: Definition to come...

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About NPI 1447017082

August Bruce Wagner's National Provider Identifier is 1447017082, issued on Feb 29, 2024. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Portland, OR. The record was last updated on Feb 29, 2024.