Gina Maria Waggoner, GINA WAGGONER, MAC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LH00009537 Issued in WA

Practice address

518 Pecks Dr
Everett, WA 98203-4405

Phone

(425) 220-1110

NPI assigned

May 21, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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

Other identifiers 1

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": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457560021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20403 81ST DR NE",
            "city": "ARLINGTON",
            "state": "WA",
            "postal_code": "982235969",
            "telephone_number": "425-220-1110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "518 PECKS DR",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982034405",
            "telephone_number": "425-220-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGGONER",
        "first_name": "GINA",
        "middle_name": "MARIA",
        "name_prefix": "Mrs.",
        "credential": "GINA WAGGONER, MAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH00009537",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRIME VICTIMS COMPENSATIO",
            "identifier": "8930359",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rafael C Wabl, MD
• Jacy Wade
• Kim K Wade
• Ronda Ann Brown Wade, MSN, FNP-BC
• Amit Wadke
• Michele E Wagner, PA-C
• Sara Wagner
• Terry J Wagner, LMP
• Jodi Jean Wagster, LMP
• Gina Lillie-Ann Wahl, CMA

• Mental Health Counselor in Everett, WA
• Providers in Everett, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.