Robert Eugene Wagner, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH3390 Issued in WA

Practice address

10324 Canyon Rd East
#105
Puyallup, WA 98373

Phone

(253) 537-6000

Fax

(253) 539-1471

NPI assigned

Jan 23, 2007

Last updated

Dec 31, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - West Sunnyvale, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1230681600000",
    "number": "1932253036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10324 CANYON ROAD EAST",
            "address_2": "#105",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "98373",
            "telephone_number": "253-537-6000",
            "fax_number": "253-539-1471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10324 CANYON RD EAST",
            "address_2": "#105",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "98373",
            "telephone_number": "253-537-6000",
            "fax_number": "253-539-1471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "ROBERT",
        "middle_name": "EUGENE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2008-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00003390",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH3390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Konhzoua Vue, OTR
• Ann Waddell
• Zerka Wadood, M.D.
• Clark M Waffle, M.D.
• Allison Jones Waggoner
• Steven William Wagner
• Tiffany Wagner, LMP
• Valerie Ann Wagoner, SLP
• Jeffrey Allen Waguespack, MSPT
• Kassondra Wagy, ARNP

• Chiropractor in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Chiropractor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.