Jessica Leigh Wagner, M.ED., B.S.

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

CG60389811 Issued in WA

Practice address

901 N Monroe St
Suite 200
Spokane, WA 99201-2104

Phone

(509) 328-2740

Fax

(509) 328-0773

NPI assigned

Jul 1, 2013

Last updated

Jul 1, 2013By the provider in NPPES

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

Other names 1

• Jessica Leigh Wagner Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science, Master of Education

State licenses

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

{
    "created_epoch": "1372636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372636800000",
    "number": "1558701839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 N MONROE ST",
            "address_2": "SUITE 200",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992012104",
            "telephone_number": "509-328-2740",
            "fax_number": "509-328-0773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 N MONROE ST",
            "address_2": "SUITE 200",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992012104",
            "telephone_number": "509-328-2740",
            "fax_number": "509-328-0773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "JESSICA",
        "middle_name": "LEIGH",
        "credential": "M.ED., B.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-01",
        "last_updated": "2013-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "WA",
            "license": "CG60389811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "WAGNER",
            "middle_name": "LEIGH",
            "credential": "M.ED., B.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amy Lyn Wagner, MOTR/L
• Ariel Linn Wells Wagner, RN
• Druscilla Isabelle Wagner
• Elise Wagner, CPC, AAC
• Hope E Wagner, RN
• Kerri Donna Wagner, CRNA
• Kristin Jo Wagner
• Linelle Wagner
• Melanie A Wagner
• Natalie Rose Wagner, LMHCA

• Behavior Analyst in Spokane, WA
• Providers in Spokane, WA by specialty
• Behavior Analyst in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2013; 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.