Jessica Wagner, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

016454 Issued in OR

Practice address

200 N Monroe St
Eugene, OR 97402-4243

Phone

(541) 790-7638

NPI assigned

Apr 25, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1714003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1356197875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 E 23RD AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974053075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N MONROE ST",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974024243",
            "telephone_number": "541-790-7638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "JESSICA",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-25",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OR",
            "license": "016454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karl Wagenknecht, D.M.D.
• Stephanie Ann Wagers, OTR/L
• Jamie Lynn Waggoner, RN, BSN
• Angela Wagner, LCSW
• Casey Jo Wagner
• Lisa A Wagner, SLP
• Mary Beth Wagner
• Megan Marie Wagner, D.C.
• Meghan Elisabeth Wagner, QMHP
• Alexander Wagnon, BS

• Speech-Language Pathologist in Eugene, OR
• Providers in Eugene, OR by specialty
• Speech-Language Pathologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 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.