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James Everett Wagner, BS,QMHA
Peer Specialist in Medford, Oregon
NPI 1952842346

James Everett Wagner is a Peer Specialist based in Grants Pass, OR. James Everett Wagner practices in Medford, OR and has the professional credentials of BS,QMHA. The NPI Number for James Everett Wagner is 1952842346 and holds a License No. (Oregon).

The current practice location address for James Everett Wagner is 1175 E Main St Ste 1C, Medford, OR and can be reached out via phone at 541-772-0127.

Location: 1175 E Main St Ste 1C, Medford, OR, 97527-5500
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1952842346
Provider Name
James Everett Wagner
Credential
BS,QMHA
Provider Entity Type
Individual
Gender
Male
Address
1175 E Main St Ste 1C, Medford, OR, 97527-5500
Phone Number
541-772-0127
Fax Number
Provider Enumeration Date
03/17/2017
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1952842346 05 OR
institution
Provider Business Practice Location Address Details
Address
1175 E Main St Ste 1C
City
Medford
State
Oregon
Zip
97504-7457
Phone Number
541-772-0127
Fax Number
person
Provider Business Mailing Address Details
Address
1175 E Main St Ste 1C
City
Medford
State
Oregon
Zip
97504-7457
Phone Number
541-772-0127
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
()
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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