Active NPI
Jane C Wagner, LMFT
- Marriage & Family Therapist
- Anacortes, WA
National Provider Identifier
1306047188
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- LF00000926
- Practice address
- 1019 21St St
Anacortes, WA 98221-2515 - Phone
- (360) 420-4100
- NPI assigned
- May 30, 2007
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | LF00000926 | WA | Primary |
Addresses
Primary practice location
1019 21St St
Anacortes, WA 98221-2515
Mailing address
15127 Gibralter Rd
Anacortes, WA 98221-8616
Phone (360) 420-4100
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 |
|---|---|---|---|
| LF00000926 | WA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1333497600000",
"number": "1306047188",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15127 GIBRALTER RD",
"city": "ANACORTES",
"state": "WA",
"postal_code": "982218616",
"telephone_number": "360-420-4100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1019 21ST ST",
"city": "ANACORTES",
"state": "WA",
"postal_code": "982212515",
"telephone_number": "360-420-4100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGNER",
"first_name": "JANE",
"middle_name": "C",
"name_prefix": "Ms.",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-30",
"last_updated": "2012-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "WA",
"license": "LF00000926",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anacortes, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.