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TYLER VAN WAGENEN, PA

PA

Physician Assistant

NPI: 1700656352IndividualAccepts Medicare

Specialties, Licenses & Credentials

Physician AssistantPrimary

Physician Assistant

Code: 363A00000X

PA219187(OR)PA2766(ID)

CMS Specialties

Education

OTHER

Class of 2023

Contact & Hours

Address
2327 SW 4TH AVE
ONTARIO, OR 97914

Quick Facts

NPI
1700656352
Entity Type
Individual
Gender
Male
Medicare
Accepted
Specialties
2
Locations
1
Years in Practice
3

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