Cameron Kay Wagner, L.M.T

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

12739 Issued in OR

Practice address

2935 Marine Dr
Astoria, OR 97103-2831

Phone

(503) 298-8517

NPI assigned

May 7, 2007

Last updated

Jul 8, 2007By 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

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": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629281944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 EXCHANGE ST",
            "city": "ASTORIA",
            "state": "OR",
            "postal_code": "971034625",
            "telephone_number": "503-298-8517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2935 MARINE DR",
            "city": "ASTORIA",
            "state": "OR",
            "postal_code": "971032831",
            "telephone_number": "503-298-8517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "CAMERON",
        "middle_name": "KAY",
        "credential": "L.M.T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "12739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Massage Therapist in Astoria, OR
• Providers in Astoria, OR by specialty
• Massage Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.