Matthew Gary Waddingham, CO

Primary specialty

SpecialistTaxonomy code 174400000X

License

OI60206377 Issued in WA

Practice address

34709 9TH Ave S
Suite a-100
Federal Way, WA 98003-8722

Phone

(253) 952-3887

Fax

(253) 927-3058

NPI assigned

Mar 3, 2011

Last updated

Mar 3, 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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Preferred Orthotic and Prosthetic Services Inc

  dba Evergreen Prosthetics and Orthotics

  • Prosthetic/Orthotic Supplier
  • Federal Way, WA
  • NPI 1689713265
  NPD (past)

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

{
    "created_epoch": "1299110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299110400000",
    "number": "1538467329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 S CEDAR ST",
            "address_2": "SUITE 202",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984052308",
            "telephone_number": "253-572-1282",
            "fax_number": "253-572-1175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34709 9TH AVE S",
            "address_2": "SUITE A-100",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980038722",
            "telephone_number": "253-952-3887",
            "fax_number": "253-927-3058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADDINGHAM",
        "first_name": "MATTHEW",
        "middle_name": "GARY",
        "credential": "CO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-03",
        "last_updated": "2011-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "OI60206377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hau Thi-Le Vu
• Ngoc Diep Vu, PA-C
• Van H Vuong, DDS
• Rhoda Wangui Wachira
• Kathleen Patricia Waddell, FNP
• Caitlin Wade, LMFTA
• Emily Wagler, DPM
• Audrey Wagner, MS, CCC-SLP
• Kaitlin Wagner, DPT
• Sara Jagels Wagner, PA-C

• Specialist in Federal Way, WA
• Providers in Federal Way, WA by specialty
• Specialist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.