Active NPI
Bonita Wegenast, LMP
- Specialist
- Friday Harbor, WA
National Provider Identifier
1154627958
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MA00014562
- Practice address
- 580 Guard St
Friday Harbor, WA 98250-8044 - Phone
- (360) 370-5118
- NPI assigned
- Jan 27, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MA00014562 | WA | Primary |
Addresses
Primary practice location
580 Guard St
Friday Harbor, WA 98250-8044
Mailing address
153 Cordova LN
Friday Harbor, WA 98250-8435
Phone (306) 370-5118
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA00014562 | WA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1296086400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1296086400000",
"number": "1154627958",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "153 CORDOVA LN",
"city": "FRIDAY HARBOR",
"state": "WA",
"postal_code": "982508435",
"telephone_number": "306-370-5118"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "580 GUARD ST",
"city": "FRIDAY HARBOR",
"state": "WA",
"postal_code": "982508044",
"telephone_number": "360-370-5118"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEGENAST",
"first_name": "BONITA",
"credential": "LMP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-01-27",
"last_updated": "2011-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "WA",
"license": "MA00014562",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Friday Harbor, WA
- Village at the Harbor
- John Stanford Wakeman, D.D.S.
- Lauren Wall, RN, IBCLC
- Washington Institute of Natural Sciences (W.I.N.S. Integrated Medical Clinic)
- Gary Waters, LCSW, LMFT, LADC
- Inge M. Wendelberger, M.A., CDPT
- Sarah Elizabeth Werling, MSW, LICSW
- Melissa Marie Wickey, LMT, EAMP
- Jerry Wickman, D.C.
- Robert Dean Williams, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.