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Alyssa Rose Wagner, IBCLC
Lactation Consultant (Registered Nurse) in Springfield, Oregon
NPI 1700352143

Alyssa Rose Wagner is a Lactation Consultant (Registered Nurse) based in Springfield, OR and is specialized in Lactation Consultant. Alyssa Rose Wagner practices in Springfield, OR and has the professional credentials of IBCLC. The NPI Number for Alyssa Rose Wagner is 1700352143 and holds a License No. 201140420RN (Oregon).

The current practice location address for Alyssa Rose Wagner is 353 Deadmond Ferry Rd, Springfield, OR and can be reached out via phone at 541-337-4970.

Location: 353 Deadmond Ferry Rd, Springfield, OR, 97477-9406
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1700352143
Provider Name
Alyssa Rose Wagner
Credential
IBCLC
Provider Entity Type
Individual
Gender
Female
Address
353 Deadmond Ferry Rd, Springfield, OR, 97477-9406
Phone Number
541-337-4970
Fax Number
Provider Enumeration Date
10/23/2018
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
L-144285 01 OR IBLCE
institution
Provider Business Practice Location Address Details
Address
353 Deadmond Ferry Rd
City
Springfield
State
Oregon
Zip
97477-9406
Phone Number
541-337-4970
Fax Number
person
Provider Business Mailing Address Details
Address
353 Deadmond Ferry Rd
City
Springfield
State
Oregon
Zip
97477-9406
Phone Number
541-337-4970
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing Service Providers
Classification
Registered Nurse
Speciality
Lactation Consultant
Taxonomy
163WL0100X
License No.
201140420RN (Oregon)
Definition
Definition to come...
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