MS. AMANDA DIANE WAGNER (NPI# 1467891994) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467891994 |
| Entity Type | Individual |
| Full Name | MS. AMANDA DIANE WAGNER |
| Credential | R.D. |
| Practice Address |
9040 Jackson Avenue Tacoma WA 98431-7311 |
| Mailing Address |
5405 Tuckerman Ln Apt 425 Rockville MD 20852-7311 |
| Practice Telephone | 3529681631 |
| Mailing Telephone | 3014002702 |
| Enumeration Date | 2013-06-18 |
| Last Update Date | 2019-08-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | Dietary & Nutritional Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932707072 | Amanda Lynn Wagner | In Home Supportive Care | 158 Fairhome Ave, Clyde, OH 43410-2006 | 2020-10-12 |
| 1205478294 | Amanda Wagner | Marriage & Family Therapist | 7021 W 153rd St Ste 5, Orland Park, IL 60462-5397 | 2019-10-11 |
| 1144683574 | Amanda Wagner | Counselor | 900 Darlington Ave, Mahwah, NJ 07430-2526 | 2016-04-02 |
| 1659748911 | Amanda E Wagner | Clinical Neuropsychologist | 2000 Alameda De Las Pulgas Ste 242, San Mateo, CA 94403-1271 | 2015-08-21 |
| 1295090504 | Amanda Wagner | Speech-Language Pathologist | 120 Se 5th Ave, Apt 223, Boca Raton, FL 33432-5072 | 2012-07-12 |
| 1154399152 | Amanda Griffin Wagner | Psychologist | 11 Charlie Morris Rd Bldg 2, Colbert, GA 30628-2445 | 2006-03-08 |
| 1396365797 | Amanda Wagner | Pharmacist | 1 Wyoming St, Dayton, OH 45409-2722 | 2020-04-26 |
| 1164058020 | Amanda C Wagner | Nurse Anesthetist, Certified Registered | 5645 Main St, Flushing, NY 11355-5045 | 2020-03-22 |
| 1780214320 | Amanda Wagner | Case Manager/Care Coordinator | 1744 Payne Ave, Cleveland, OH 44114-2910 | 2020-01-23 |
| 1366089914 | Amanda Wagner | Case Manager/Care Coordinator | 120 S Barstow St, Eau Claire, WI 54701-3642 | 2019-12-03 |
| Street Address |
9040 JACKSON AVENUE |
| City | TACOMA |
| State | WA |
| Zip Code | 98431-7311 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811995525 | Lee A Antles | Internal Medicine | 9040 Jackson Avenue, Tacoma, WA 98431-8151 | 2005-07-07 |
| 1770117640 | Ryan Bradley Liberg | Student in an Organized Health Care Education/Training Program | 9040 Jackson Avenue, Tacoma, WA 98431-0001 | 2020-02-28 |
| 1255965588 | Travis Dunn | Student in an Organized Health Care Education/Training Program | 9040 Jackson Avenue, Tacoma, WA 98431-0001 | 2020-02-25 |
| 1538792023 | Christopher Hodge | Student in an Organized Health Care Education/Training Program | 9040 Jackson Avenue, Tacoma, WA 98431-0001 | 2020-02-13 |
| 1689206187 | Joscelyn Eva Hodge | Student in an Organized Health Care Education/Training Program | 9040 Jackson Avenue, Tacoma, WA 98431-0001 | 2020-02-12 |
| 1770115719 | Michael W Patt | Student in an Organized Health Care Education/Training Program | 9040 Jackson Avenue, Tacoma, WA 98431-0001 | 2020-02-07 |
| 1780228973 | Christopher Conner | Physician Assistant | 9040 Jackson Avenue, Tacoma, WA 98431-0001 | 2019-10-31 |
| 1417500638 | Eugenia Ann Haley | Social Worker | 9040 Jackson Avenue, Tacoma, WA 98431-1072 | 2019-07-17 |
| 1811556269 | Erika May | Registered Nurse | 9040 Jackson Avenue, Tacoma, WA 98431-0001 | 2019-06-10 |
| 1417510330 | Margaret Jayne Ramsdell | Case Manager/Care Coordinator | 9040 Jackson Avenue, Tacoma, WA 98431-0001 | 2019-04-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497212260 | Catrina Renee Grugin | Registered Nurse | Madigan Army Medical Center, Attn Mchj-clq-c, 9040 Jackson Ave, Tacoma, WA 98431 | 2019-02-27 |
| 1801307681 | Bianca Gomez | Dental Assistant | Bldg 9900 Lincoln Street, Jblm, WA 98431 | 2017-10-19 |
| 1184133225 | Darren Paris | Registered Nurse | Madigan Army Medical Center 9040 Jackson Ave., Attn: Mchj-clq-c, Tacoma, WA 98431 | 2017-09-20 |
| 1922538206 | Sarah Frerichs | Dentist | Madigan Annex, Second Floor, Bldg. 9900, Apo, AA 98431 | 2017-06-19 |
| 1740736495 | Misty Hill | Dental Assistant | 9119 Mill Park Ave, Tacoma, WA 98431 | 2016-08-31 |
| 1336695535 | Jacqueline D Massouda | Dentist | Jblm Dentac, 9900 Lincoln Sreet, 2nd Floor, Apo, AA 98431 | 2016-08-28 |
| 1609239375 | Gregg V Palmer | Licensed Practical Nurse | 17th and C Street, Bldg 11582, Tacoma, WA 98431 | 2016-03-31 |
| 1114323904 | Deanna Sheets | Nurse Practitioner | 911 Mil Park Ave, Tacoma, WA 98431 | 2014-11-06 |
| 1679905434 | Austin William Schaar | Dentist | Building 9900, 2nd Floor, Tacoma, WA 98431 | 2013-08-05 |
| 1518209758 | Maurice Ibrahim Khayat | Internal Medicine | 9040 Jackson Ave Mche-qd (creds), Tacoma, WA 98431 | 2013-03-26 |
| Find all providers in zip 98431 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518586007 | Paige Worley | Dietitian, Registered | 3905 N 36th St, Tacoma, WA 98407-5634 | 2020-04-14 |
| 1659933554 | Julia Budniak | Dietitian, Registered | 9040 Jackson Street, Tacoma, WA 98431-0001 | 2019-07-01 |
| 1740755636 | Erika Mary Clough | Dietitian, Registered | 3401 S 19th St Ste 100, Tacoma, WA 98405-1909 | 2018-10-08 |
| 1417422577 | Paul Holthaus | Dietitian, Registered | 9040 Jackson Ave Nutrition Clinic, Tacoma, WA 98431-0001 | 2018-10-04 |
| 1003320078 | Christina Stapke | Dietitian, Registered | 1624 South I St. Ste 205, Tacoma, WA 98405 | 2017-11-28 |
| 1023530227 | Alexandra Alyse Mckee | Dietitian, Registered | 233 St Helens Ave Apt 403, Tacoma, WA 98402-2585 | 2017-07-10 |
| 1407386287 | Amber E Lagerwey | Dietitian, Registered | 15703 Pacific Ave S Ste B, Tacoma, WA 98444-4675 | 2017-06-14 |
| 1578011425 | Kyleigh Harlow | Dietitian, Registered | 11011 Park Ave S, C212, Tacoma, WA 98444 | 2016-09-20 |
| 1528439718 | Hannah Lima | Dietitian, Registered | 12615 26th Ave E, Tacoma, WA 98445-5014 | 2015-10-13 |
| 1871907519 | Anne B Corley | Dietitian, Registered | 2102 N Pearl St Ste 405, Tacoma, WA 98406-2550 | 2014-06-19 |
| Find all providers in TACOMA | ||||
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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.