Active NPI
Kaja Wagner
- Psychiatric Pharmacist
- Salem, OR
National Provider Identifier
1902354764
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric Pharmacist
- License
- RPH-0015583
- Practice address
- Oregon State Hospital 2600 Center St NE
Pharmacy Department
Salem, OR 97301 - Phone
- (425) 221-0947
- Fax
- (503) 947-1085
- NPI assigned
- Sep 21, 2016
- 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 |
|---|---|---|---|---|
| Psychiatric Pharmacist | 1835P1300X | RPH-0015583 | OR | Primary |
Addresses
Primary practice location
Oregon State Hospital 2600 Center St NE
Pharmacy Department
Salem, OR 97301
Mailing address
Oregon State Hospital 2600 Center St NE
Pharmacy Department
Salem, OR 97301
Phone (425) 221-0947
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH-0015583 | OR | MD | Psychiatric Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1474416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1474416000000",
"number": "1902354764",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "OREGON STATE HOSPITAL 2600 CENTER ST NE",
"address_2": "PHARMACY DEPARTMENT",
"city": "SALEM",
"state": "OR",
"postal_code": "97301",
"telephone_number": "425-221-0947",
"fax_number": "503-947-1085"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "OREGON STATE HOSPITAL 2600 CENTER ST NE",
"address_2": "PHARMACY DEPARTMENT",
"city": "SALEM",
"state": "OR",
"postal_code": "97301",
"telephone_number": "425-221-0947",
"fax_number": "503-947-1085"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGNER",
"first_name": "KAJA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-21",
"last_updated": "2016-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "1835P1300X",
"taxonomy_group": "",
"desc": "Pharmacist, Psychiatric",
"state": "OR",
"license": "RPH-0015583",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salem, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.