Active NPI
Cecile R Gagner, L.M.P.
- Contractor
- Auburn, WA
National Provider Identifier
1508070533
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- MA00012142
- Practice address
- 821 Harvey Rd
Auburn, WA 98002-4225 - Phone
- (253) 833-1833
- Fax
- (253) 833-4642
- NPI assigned
- May 9, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | MA00012142 | WA | Primary |
Addresses
Primary practice location
821 Harvey Rd
Auburn, WA 98002-4225
Mailing address
19507 99TH St. CT. E.
Bonney Lake, WA 98391
Phone (253) 833-1833
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA00012142 | WA | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1508070533",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19507 99TH ST. CT. E.",
"city": "BONNEY LAKE",
"state": "WA",
"postal_code": "98391",
"telephone_number": "253-833-1833",
"fax_number": "253-833-4642"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "821 HARVEY RD",
"city": "AUBURN",
"state": "WA",
"postal_code": "980024225",
"telephone_number": "253-833-1833",
"fax_number": "253-833-4642"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAGNER",
"first_name": "CECILE",
"middle_name": "R",
"name_prefix": "Mrs.",
"credential": "L.M.P.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "WA",
"license": "MA00012142",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Auburn, WA
Sources for this page
- 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.