Luke William Waggoner

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CG60117524 Issued in WA

Practice address

1520 Kelley PL
Walla Walla, WA 99362-8654

Phone

(509) 524-2920

NPI assigned

Mar 2, 2011

Last updated

Mar 2, 2011By 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

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

{
    "created_epoch": "1299024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299024000000",
    "number": "1518265347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1595",
            "address_2": "1520 KELLY PLACE",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993620329",
            "telephone_number": "509-524-2920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 KELLEY PL",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993628654",
            "telephone_number": "509-524-2920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGGONER",
        "first_name": "LUKE",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-02",
        "last_updated": "2011-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "CG60117524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vision Source Walla Walla
• Vision Source Walla Walla PLLC
• Rhonda Rae Vocht, RN
• Shirley Robin Vonhaven, DO
• Minh N Vu, L.AC.
• Janalee Wagner, DSW, MSW, LICSW
• Lauren Wagner
• William D Wagner, D.O.
• Walgreen Co (Walgreens #10107)
• Brian Walker, M.D.

• Mental Health Counselor in Walla Walla, WA
• Providers in Walla Walla, 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 Mar 2, 2011; 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.