David G. Wagner, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD07158 Issued in OR

Practice address

9250 SW Hall Blvd
Tigard, OR 97223-6857

Phone

(503) 293-0161

Fax

(503) 452-3200

NPI assigned

Aug 2, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291766400000",
    "number": "1265449193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9250 SW HALL BLVD",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972236857",
            "telephone_number": "503-293-0161",
            "fax_number": "503-452-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9250 SW HALL BLVD",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972236857",
            "telephone_number": "503-293-0161",
            "fax_number": "503-452-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "DAVID",
        "middle_name": "G.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2010-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD07158",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "240978",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vpa PC (HarmonyCares Medical Group)
• Huy D. Vu
• Siulolovao Fangafua Vuna
• Chandra Wade-Rogers, RDH
• Janelle Waggy
• Marina Alyssa Wagner, DO
• Mark Bastian Wagner, M.D.
• Windy Wahlke
• Allison Marie Walbridge
• Florence Anne Waldal, RPH

• Family Medicine Physician in Tigard, OR
• Providers in Tigard, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.