Denette Ann Wagner, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW61281864 Issued in WA

Practice address

2321 W Dayton Airport Rd
Shelton, WA 98584-6319

Phone

(360) 426-4433

NPI assigned

May 7, 2025

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

State licenses

Practice roles

Locations

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

• Washington State Department of Corrections Washington Corrections Cent

  • Prison Health Clinic/Center
  • Shelton, WA
  • NPI 1447541834
  NPD

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

{
    "created_epoch": "1746576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1548050156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7345 LINDERSON WAY SW",
            "city": "TUMWATER",
            "state": "WA",
            "postal_code": "985016504",
            "telephone_number": "360-725-8213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2321 W DAYTON AIRPORT RD",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985846319",
            "telephone_number": "360-426-4433"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7345 Linderson Way SW",
            "address_purpose": "LOCATION",
            "city": "Tumwater",
            "state": "WA",
            "postal_code": "985016504",
            "country_code": "US",
            "telephone_number": "360-725-8213",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "DENETTE",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-07",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW61281864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dorothy L Vella
• Alexa Villanueva
• Monica Eileen Vinson, MS, CCC-SLP
• Vista Oncology Inc. PS
• Monica B Vuong, MD
• Britne Lynn Wakem, PHARMD
• Wal-Mart Stores, Inc
• Kylie Lynn Walker
• Sherry Chemoke Waller, LCSW
• Walmart Inc.

• Clinical Social Worker in Shelton, WA
• Providers in Shelton, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2025; 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.