Amanda Diane Wagner, R.D.

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Practice address

9040 Jackson Avenue
Tacoma, WA 98431-7311

Phone

(352) 968-1631

NPI assigned

Jun 18, 2013

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

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

{
    "created_epoch": "1371513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566777600000",
    "number": "1467891994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5405 TUCKERMAN LN APT 425",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208527311",
            "telephone_number": "301-400-2702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVENUE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984317311",
            "telephone_number": "352-968-1631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "AMANDA",
        "middle_name": "DIANE",
        "name_prefix": "Ms.",
        "credential": "R.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-18",
        "last_updated": "2019-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaylea Wade
• Madison Dior Wade
• Dawn Rachelle Wadleigh, LM, CPM
• Troy W Wadsworth, M.D.
• Sabina A Wagner-Lewis, MSW
• Danaka Wagner
• David Wagner, D.D.S.
• Erik Joseph Wagner, OTR/L
• Kelsey Ruth Wagner
• Marie Wagner

• Registered Dietitian in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Registered Dietitian in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2019; 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.