Shannon Rose Wagner, OTD, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

350329 Issued in OR

Practice address

27501 SW 95TH Ave Ste 960
Wilsonville, OR 97070-7713

Phone

(503) 657-8903

Fax

(503) 266-8632

NPI assigned

Oct 6, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1633478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771459200000",
    "number": "1407518616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 HIGH ST",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970452241",
            "telephone_number": "503-657-8903",
            "fax_number": "503-266-8632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27501 SW 95TH AVE STE 960",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970707713",
            "telephone_number": "503-657-8903",
            "fax_number": "503-266-8632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "SHANNON",
        "middle_name": "ROSE",
        "name_prefix": "Dr.",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-06",
        "last_updated": "2026-02-19",
        "certification_date": "2026-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OR",
            "license": "350329",
            "primary": true
        },
        {
            "code": "225XE0001X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Environmental Modification",
            "state": "OR",
            "license": "350329",
            "primary": false
        },
        {
            "code": "225XM0800X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Mental Health",
            "state": "OR",
            "license": "350329",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aimee Votaw
• April Voves, ND
• Madeline Wagar
• Christian Micaiah Wagner
• Lindsey Ann Wagner, OTR/L
• Shannon Renae Wakem, OTR, CHT
• Elizabeth Walden, M.A., CCC-SLP
• Walgreen Co
• Candace Lyn Walhood, P.T.
• Brice Walker

• Occupational Therapist in Wilsonville, OR
• Providers in Wilsonville, OR by specialty
• Occupational Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2026; 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.