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MS. JUNIPER ELIZABETH WAGNER
NPI 1063954428
Counselor - Mental Health in Portland, OR

Active since November 16, 2016
3036 NE MLK JR BLVD, PORTLAND, OR 97212(503) 283-3763(503) 735-0912 Get Directions Write a Review

NPPES record last updated: February 23, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 21, 2016, Nov 16, 2016 (2 updates tracked since 2016).

About Ms. Juniper Elizabeth Wagner NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. JUNIPER ELIZABETH WAGNER (NPI 1063954428) is an individual mental health provider in Portland, Oregon and active in the NPI registry since November 2016.

NPPES Registry Identity

NPI1063954428
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameMS. JUNIPER ELIZABETH WAGNER
Location Address3036 NE MLK JR BLVDPortland, OR 97212-3053
Mailing AddressPo Box 8459Portland, OR 97207-8459
Phone(503) 283-3763
Fax(503) 735-0912
Sole ProprietorNo
Enumeration DateNovember 16, 2016
Last NPPES UpdateFebruary 23, 20262 updates tracked since enumeration
NPPES CertifiedFebruary 23, 2026
✔ NPI 1063954428 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
Also ListedCounselorTaxonomy 101Y00000X
3036 NE MLK JR BLVD, Portland, OR 97212
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Other Names 1

Former Name (1)Mary Wagner

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ASHLEY BARDALES
Peer Specialist
3036 NE MLK JR BLVD
PORTLAND, OR 97212
Multnomah County (503) 283-3763
JENIFER PREVOST
Peer Specialist
3036 NE MLK JR BLVD
PORTLAND, OR 97212
Multnomah County (503) 283-3763
ANNDREA GLADYS VAUGHN
Case Manager/Care Coordinator
3036 NE MLK JR BLVD
PORTLAND, OR 97212
Multnomah County (503) 889-2500
JESSICA SHIRLEY CUSHMAN
Case Manager/Care Coordinator
3036 NE MLK JR BLVD
PORTLAND, OR 97212
Multnomah County (503) 283-3763
BENJAMIN MICHAEL DAVIDSON
Student in an Organized Health Care Education/Training Program
3036 NE MLK JR BLVD
PORTLAND, OR 97212
Multnomah County (503) 283-3763
MADELEINE ROSE POTTER PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
3036 NE MLK JR BLVD
PORTLAND, OR 97212
Multnomah County (503) 283-3763
PHILIP JOHN MAGGI
Counselor (Addiction (Substance Use Disorder))
3036 NE MLK JR BLVD
PORTLAND, OR 97212
Multnomah County (503) 283-3763
JEFFREY SCOTT DODGE
Case Manager/Care Coordinator
3036 NE MLK JR BLVD
PORTLAND, OR 97212
Multnomah County (503) 889-2500

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Juniper Wagner's NPI number?

The NPI number for Juniper Wagner is 1063954428. It was assigned to this individual provider in the NPPES registry on November 16, 2016. The provider is also known as Mary Wagner.

Where is Juniper Wagner located?

Juniper Wagner practices at 3036 NE Mlk Jr Blvd, Portland, OR 97212. The listed phone number is (503) 283-3763.

What is Juniper Wagner's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Juniper Wagner was last updated on February 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.