Shaylene Tamara Waggoner, BSN, RN

NPI #1669017513 in Gresham, Oregon

Provider Information

NPI Number: 1669017513
Entity Type: Individual
Name: Shaylene Tamara Waggoner, BSN, RN
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Registered Nurse
Credential: BSN, RN
Enumeration Date: Nov 14, 2019
Last Updated: Nov 14, 2019

Practice Location

Address: 4101 NE DIVISION ST
City: Gresham
State: Oregon
ZIP Code: 97030-4617
Phone: (503) 666-6575

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Registered Nurse	163W00000X	Primary

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