Tina Marie Wagner

Primary specialty

CounselorTaxonomy code 101Y00000X

License

LH00010770 Issued in WA

Practice address

980 Eastmont Ave
East Wenatchee, WA 98802-6602

Phone

(509) 662-6000

NPI assigned

Aug 23, 2010

Last updated

Feb 21, 2025By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Columbia Valley Community Health

  • Federally Qualified Health Center (FQHC)
  • Wenatchee, WA
  • NPI 1487650636
  Medicare reassignment NPD
• Columbia Valley Community Health

  dba 980 East Behavioral

  • Federally Qualified Health Center (FQHC)
  • East Wenatchee, WA
  • NPI 1174417919
  NPD
• Columbia Valley Community Health

  dba CVCH Behavioral Health

  • Federally Qualified Health Center (FQHC)
  • Wenatchee, WA
  • NPI 1346266152
  NPD
• Children's Home Society

  • Adolescent and Children Mental Health Clinic/Center
  • Wenatchee, WA
  • NPI 1376056796
  NPD (past)
• Children's Home Society of Washington

  dba Akin

  • Community/Behavioral Health Agency
  • Wenatchee, WA
  • NPI 1174601611
  NPD (past)

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

{
    "created_epoch": "1282521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1770899270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 ORONDO AVE STE 1",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988012800",
            "telephone_number": "509-662-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 EASTMONT AVE",
            "city": "EAST WENATCHEE",
            "state": "WA",
            "postal_code": "988026602",
            "telephone_number": "509-662-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "140 Easy Way",
            "address_purpose": "LOCATION",
            "city": "Wenatchee",
            "state": "WA",
            "postal_code": "988018108",
            "country_code": "US",
            "telephone_number": "509-662-4296",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "TINA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-23",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "LH00010770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vision Menagerie LLC
• Paula C Vodegel, LMP
• Martha Von Reis, ARNP
• Cara Lynn Vu, PHARMD
• J Mark Wade, DDS
• Walgreen Co (Walgreens #13971)
• Brian Walter, R.PH, PHARM.D
• Washington Valley Pharmacy LLC
• James Dustin Webb, DMD
• Ronald L. Wellbaum, DDS

• Counselor in East Wenatchee, WA
• Providers in East Wenatchee, WA by specialty
• Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.