Jeffrey Daniel Wagaman, PH.D.

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

PY1722 Issued in WA

Practice address

2100 Caton Way SW
Olympia, WA 98502-1105

Phone

(360) 866-7406

Fax

(360) 570-3325

NPI assigned

Mar 25, 2007

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

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Wagaman Enterprises IncGroup PAC ID 0345388641, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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 and National Provider Directory roles.

• Wagaman Enterprises Inc

  • Psychologist
  • Olympia, WA
  • NPI 1740461854
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1174780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256601600000",
    "number": "1447377221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 CATON WAY SW",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985021105",
            "telephone_number": "360-866-7406",
            "fax_number": "360-570-3325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 CATON WAY SW",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985021105",
            "telephone_number": "360-866-7406",
            "fax_number": "360-570-3325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGAMAN",
        "first_name": "JEFFREY",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-25",
        "last_updated": "2009-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "WA",
            "license": "PY1722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ann L Wade, PT CMPT
• Sarah Jean Wade
• Kim Wadsworth, DO
• Wagaman Enterprises Inc
• Christina Wagaman, R.D.
• Joel R. Wagaman, PH.D.
• Susan Lyn Wagaman, LMHCA
• John W. Waggoner III, M.D.
• Zoe Waggoner, MA, LMHC
• Binod Wagle, MD

• Counseling Psychologist in Olympia, WA
• Providers in Olympia, WA by specialty
• Counseling Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.