Katje Wagner, PHD, LPC

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

1942 NW Kearney St Ste 23
Portland, OR 97209-1465

Phone

(503) 313-5733

NPI assigned

Feb 28, 2008

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1204156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1114196680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1942 NW KEARNEY ST STE 23",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972091465",
            "telephone_number": "503-313-5733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1942 NW KEARNEY ST STE 23",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972091465",
            "telephone_number": "503-313-5733"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4735 NE 75th Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972183829",
            "country_code": "US",
            "telephone_number": "503-313-5733",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "KATJE",
        "name_prefix": "Dr.",
        "credential": "PHD, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-28",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey David Wagner, DNP, ARNP
• Jessica Wagner, LICSW
• Juniper Elizabeth Wagner
• Karin E Wagner, CERTIFIED ROLFER LMT
• Kathryn Wagner, MD
• Nan Nelson Wagner, RRT
• Robert Frederick Wagner, D.M.D.
• Stephanie Nicole Wagner
• Stephen C Wagner, D.C.
• Tamara L Wagner, MD

• Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.