KEVIN RICHARD WANDLER (NPI# 1205956265) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205956265 |
| Entity Type | Individual |
| Full Name | KEVIN RICHARD WANDLER |
| Credential | MD |
| Practice Address |
888 S Hillhurst Rd Ridgefield WA 98642-9063 |
| Practice Telephone | 7543003120 |
| Practice Fax Number | 9543068977 |
| Mailing Telephone | 7543003120 |
| Mailing Fax Number | 9543068977 |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2020-07-30 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084A0401X |
Psychiatry & Neurology Specialization: Addiction Medicine |
25MA10809300 | NJ | Allopathic & Osteopathic Physicians |
| N | 2084A0401X |
Psychiatry & Neurology Specialization: Addiction Medicine |
130525 | OH | Allopathic & Osteopathic Physicians |
| N | 2084A0401X |
Psychiatry & Neurology Specialization: Addiction Medicine |
DR.0055465 | CO | Allopathic & Osteopathic Physicians |
| Y | 2084A0401X |
Psychiatry & Neurology Specialization: Addiction Medicine |
MD60562814 | WA | Allopathic & Osteopathic Physicians |
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
ME110716 | FL | Allopathic & Osteopathic Physicians |
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
14421 | AZ | Allopathic & Osteopathic Physicians |
| N | 2083A0300X | 25MA10809300 | NJ |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 004007100 | 05 |
| Street Address |
888 S HILLHURST RD |
| City | RIDGEFIELD |
| State | WA |
| Zip Code | 98642-9063 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033752076 | Sarah N Wasilk | Counselor | 888 S Hillhurst Rd, Ridgefield, WA 98642-9063 | 2019-10-22 |
| 1245735158 | Kimberly Naranjo | Counselor | 888 S Hillhurst Rd, Ridgefield, WA 98642-9063 | 2018-03-25 |
| 1093266058 | Denise Wilson | Counselor | 888 S Hillhurst Rd, Ridgefield, WA 98642-9063 | 2016-10-14 |
| 1669837449 | Pacific North Recovery Center, LLC | Substance Abuse Rehabilitation Facility | 888 S Hillhurst Rd, Ridgefield, WA 98642-9063 | 2015-12-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073137741 | Oasis Dental Ridgefield | Clinic/Center | 11 S. 47th Ave. Suite 101, Ridgefiled, WA 98642 | 2020-05-29 |
| 1063055895 | Rosauers Supermarkets Inc | Pharmacy | 101 S. 47th Avenue, Ridgefield, WA 98642 | 2019-10-24 |
| 1619459070 | Alina Gwin Johnson | Behavioral Analyst | 2613 Ne 161st, Ridgefeild, WA 98642 | 2018-09-02 |
| 1710325675 | Dennis Herbert Gillespie | Dentist | 109 S. 65th Ave., Suite 104, Ridgefield, WA 98642 | 2013-06-12 |
| 1336423508 | Amanda Lepley | Counselor | 20107 Ne 29th Ave, Ridgefield, WA 98642 | 2011-10-05 |
| 1356462675 | Battle Ground Physical Therapy | Clinic/Center | 2 South 56th Place, Suite 100, Ridgefield, WA 98642 | 2007-04-03 |
| 1245365386 | Marilyn Kay Milestone | Midwife | 8004 So. 5th St., Ridgefield, WA 98642 | 2007-02-22 |
| 1346246303 | Samuel W Richard | Family Medicine | 8507 South 5th Street, Suite 113, Ridgefield, WA 98642 | 2005-06-23 |
| 1710264171 | Generations Counseling | Community/Behavioral Health | 2 South 56th Place, Suite 201-c, Ridgefield, WA 98642 | 2011-11-12 |
| 1164659488 | Jonas Aharoni | Internal Medicine | 5515 Pioneer St, Ridgefield, WA 98642 | 2009-06-12 |
| Find all providers in zip 98642 | ||||
| Taxonomy Code | 2084A0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Addiction Medicine |
| A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |
| Notes: Source: American Osteopathic Board of Neurology and Psychiatry, 2007 [1/1/2008: definition added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811155773 | Raghuram B Bhat | Psychiatry & Neurology | 417 Ne 2nd Ave Ste 205, Camas, WA 98607 | 2008-05-28 |
| 1487863999 | Phyllis Jo Henderson | Psychiatry & Neurology | 418 S 44th Ave, Yakima, WA 98908-3303 | 2007-05-21 |
| 1457410961 | Frederick A Montgomery Md Inc Ps | Psychiatry & Neurology | 215 So 11th # D, Yakima, WA 98902 | 2006-12-08 |
| 1962575951 | Marc D Pellicciaro | Psychiatry & Neurology | 12729 Northup Way Ste 6, Bellevue, WA 98005-1935 | 2006-11-16 |
| 1821188764 | Steven M Juergens | Psychiatry & Neurology | 11201 Se 8th St Ste 105, Bellevue, WA 98004-6420 | 2006-10-13 |
| 1225666951 | Radiant Path Psychiatry Pllc | Psychiatry & Neurology | 330 King St Ste 5, Wenatchee, WA 98801-2857 | 2020-03-30 |
| 1184101073 | Luke Rosen, Do, Pllc | Psychiatry & Neurology | 2501 Ne 134th St Ste 203, Vancouver, WA 98686-3026 | 2018-07-24 |
| 1386883726 | Seema Basnett | Psychiatry & Neurology | 10001 17th Pl S, Lower Level, Seattle, WA 98168-1615 | 2009-02-09 |
| 1093921660 | Allison Evans Gullo | Psychiatry & Neurology | 6926 Ne Fourth Plain Blvd, Vancouver, WA 98661-7369 | 2007-05-14 |
| 1497880355 | John R Moran | Psychiatry & Neurology | 12101 Ambaum Blvd Sw, Burien, WA 98146-2651 | 2007-02-22 |
| Find all providers with the same taxonomy | ||||
| City | RIDGEFIELD |
| Zip Code | 98642 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.