Individual provider · Type 1 NPI

Lisa Wagoner, P.T.A.

Physical Therapy Assistant · Medford, OR

NPI number 1508124199 Active

Practice location

400 Crater Lake Ave
Medford, OR 97504-6808

Call (541) 613-6505 Map

Mailing address

113 N Elm St
Canby, OR 97013-3519

Specialties and licenses

TaxonomyCodeLicense
Physical Therapy Assistant 225200000XPTA-2842 (ID)
Physical Therapy Assistant Primary 225200000X8785 (OR)

Physical Therapy Assistant: (1)Physical therapist assistants are skilled health care providers who are graduates of a physical therapist assistant associate degree program accredited by an agency recognized by the Secretary of the U.S. Department of Education or Council on Postsecondary Accreditation, who assists the physical therapist in providing physical therapy. The supervising physical therapist is directly responsible for the actions of …

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About NPI 1508124199

Lisa Wagoner, P.T.A.'s National Provider Identifier is 1508124199, issued on May 2, 2012. The primary taxonomy on file is Physical Therapy Assistant (225200000X), and the practice location is in Medford, OR. The record was last updated on May 1, 2023.