August Bruce Wagner

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

R8260 Issued in OR

Practice address

333 SW Taylor St Ste 200
Portland, OR 97204-2446

Phone

(503) 446-2500

NPI assigned

Feb 29, 2024

Last updated

Feb 29, 2024By the provider in NPPES

Sex

Male

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

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Relational Roots, LLC

  • Marriage & Family Therapist
  • Portland, OR
  • NPI 1184431355
  NPD Authorized official

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

{
    "created_epoch": "1709164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709164800000",
    "number": "1447017082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17570 NW CORNELL RD APT 7",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970068641",
            "telephone_number": "970-567-5203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 SW TAYLOR ST STE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972042446",
            "telephone_number": "503-446-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "AUGUST",
        "middle_name": "BRUCE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-29",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "R8260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wagner Family Dentistry
• Susan Lyn Wagner-Debusman, RN
• Abigail Wagner
• Amy W Wagner, PH.D.
• Audrey Wagner
• Benjamin Wagner, MD
• Cindy Wagner
• Corey Wagner
• David Wagner, PHD
• Emily Hazel Wagner

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 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.