DR. Shannon Rose Wagner, OTD, OTR/L, CCTP

NPI #1407518616 in Sherwood, Oregon

Provider Information

NPI Number: 1407518616
Entity Type: Individual
Name: DR. Shannon Rose Wagner, OTD, OTR/L, CCTP
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Occupational Therapist
Credential: OTD, OTR/L, CCTP
Enumeration Date: Oct 6, 2021
Last Updated: Oct 6, 2021

Practice Location

Address: 23286 SW CINNAMON HILL PL
City: Sherwood
State: Oregon
ZIP Code: 97140-8927
Phone: (503) 888-6993

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist - Environmental Modification — Environmental Modification	225XE0001X
Occupational Therapist - Mental Health — Mental Health	225XM0800X
Occupational Therapist	225X00000X	Primary

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