Active NPI
Amanda Corilyn Wagaman
- Student in an Organized Health Care Education/Training Program
- Tumwater, WA
National Provider Identifier
1609503507
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 1992 Ridgeview Loop SW Apt 206
Tumwater, WA 98512-1455 - Phone
- (360) 584-2344
- NPI assigned
- Aug 2, 2022
- Last updated
- Aug 2, 2022
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | WA | Primary |
Addresses
Primary practice location
1992 Ridgeview Loop SW Apt 206
Tumwater, WA 98512-1455
Mailing address
26812 118TH Ave. E.
Graham, WA 98338
Phone (844) 623-9675
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1659398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659398400000",
"number": "1609503507",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26812 118TH AVE. E.",
"city": "GRAHAM",
"state": "WA",
"postal_code": "98338",
"telephone_number": "844-623-9675"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1992 RIDGEVIEW LOOP SW APT 206",
"city": "TUMWATER",
"state": "WA",
"postal_code": "985121455",
"telephone_number": "360-584-2344"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGAMAN",
"first_name": "AMANDA",
"middle_name": "CORILYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-08-02",
"last_updated": "2022-08-02",
"certification_date": "2022-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "WA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tumwater, WA
- Vision Health PLLC (Vision Health)
- Vital Healthcare LLC
- Shawn Vonbargen, MA.MFT, LMHC
- Sandy Jule Vonheeder, CCC-SLP
- Vanessa Vu-Sabido, RD
- Courtney Danielle Wagaman
- Wal-Mart Stores Inc (Vision Center 30-3850)
- Walgreen Co (Walgreens #12453)
- Havannah Fay Walker, AAC CG61359168
- Mary Elizabeth Walker, RPH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.