Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Lisa Wagoner, PTA

Individual provider Physical Therapy Assistant · NPI 1508124199

Lisa Wagoner, PTA is a Physical Therapy Assistant in Medford, Oregon. Licensed in Idaho and Oregon. Registered with an NPI since 2012.

Licensed in
ID, OR
In the registry since
2012
Specialties on file
2
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

400 Crater Lake Ave
Medford, OR 97504-6808
Phone: (541) 613-6505
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 8785 (OR)
Physical Therapy Assistant Taxonomy 225200000X · Licence PTA-2842 (ID)

Record details

NPI number1508124199
Entity typeIndividual (Type 1)
GenderFemale
Credentials PTA
Sole proprietorNo
NPI enumeratedMay 2, 2012
Last updated in NPPESMay 1, 2023
Certification dateMay 1, 2023
Mailing address113 N Elm St, Canby, OR 97013-3519

Other providers in Medford