Dr Shannon Rose Wagner, OTD, OTR/L, CCTP is a
Occupational Therapist based in Sherwood, Oregon. Dr Shannon Rose Wagner is licensed to practice in Oregon (license number 350329) and her current practice location is
23286 Sw Cinnamon Hill Pl, Sherwood, Oregon. She can be reached at her office (for appointments etc.) via phone at
(503) 888-6993.
NPI number for Dr Shannon Rose Wagner is 1407518616 and her current mailing address is Po Box 1289, Sherwood, Oregon. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1407518616.
Healthcare Provider's Profile
Full Name | Dr Shannon Rose Wagner |
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Gender | Female |
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Speciality | Occupational Therapist |
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Location | 23286 Sw Cinnamon Hill Pl, Sherwood, Oregon |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1407518616
- Provider Enumeration Date: 10/06/2021
- Last Update Date: 10/06/2021
Medical Identifiers
Medical identifiers for Dr Shannon Rose Wagner such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1407518616 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
225XE0001X | Occupational Therapist - Environmental Modification | 350329 (Oregon) | Secondary |
225XM0800X | Occupational Therapist - Mental Health | 350329 (Oregon) | Secondary |
225X00000X | Occupational Therapist | 350329 (Oregon) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Shannon Rose Wagner is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Shannon Rose Wagner, OTD, OTR/L, CCTP Po Box 1289, Sherwood, OR 97140-1289 Ph: () - | Dr Shannon Rose Wagner, OTD, OTR/L, CCTP 23286 Sw Cinnamon Hill Pl, Sherwood, OR 97140-8927 Ph: (503) 888-6993 |
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