BRADY WAYNE WAGNER (NPI# 1649405671) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649405671 |
| Entity Type | Individual |
| Full Name | BRADY WAYNE WAGNER |
| Credential | M.D. |
| Practice Address |
2211 Ne 139th St Vancouver WA 98686-2742 |
| Mailing Address |
12815 Sw Rita Dr Beaverton OR 97005-0720 |
| Practice Telephone | 3604871000 |
| Mailing Telephone | 5038060647 |
| Enumeration Date | 2009-05-19 |
| Last Update Date | 2013-02-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | MD60292835 | WA | Allopathic & Osteopathic Physicians |
| Street Address |
2211 NE 139TH ST |
| City | VANCOUVER |
| State | WA |
| Zip Code | 98686-2742 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487642591 | Vivek J Murari | Internal Medicine | 2211 Ne 139th St, Vancouver, WA 98686-2742 | 2005-10-12 |
| 1174159297 | Celeste Morgan | Occupational Therapist | 2211 Ne 139th St, Vancouver, WA 98686-2742 | 2020-03-20 |
| 1497393193 | Jessica Lyn Bilger | Nurse Practitioner | 2211 Ne 139th St, Vancouver, WA 98686-2742 | 2019-12-13 |
| 1144864521 | Breanne Mary Davis | Occupational Therapist | 2211 Ne 139th St, Vancouver, WA 98686-2742 | 2019-10-29 |
| 1407336787 | Christine Garrow | Registered Nurse | 2211 Ne 139th St, Vancouver, WA 98686-2742 | 2018-08-16 |
| 1144743501 | Eric Austin Jordan Nash | Nurse Practitioner | 2211 Ne 139th St, Vancouver, WA 98686-2742 | 2017-07-18 |
| 1720528698 | Candace M Hart | Registered Nurse | 2211 Ne 139th St, Vancouver, WA 98686-2742 | 2017-02-27 |
| 1801343868 | Kathryn Norton | Pharmacist | 2211 Ne 139th St, Vancouver, WA 98686-2742 | 2016-09-07 |
| 1114381084 | Eduardo Serpa | Internal Medicine | 2211 Ne 139th St, Vancouver, WA 98686 | 2016-04-07 |
| 1699146696 | Thuan Huy Nguyen | Registered Nurse | 2211 Ne 139th St, Vancouver, WA 98686-2742 | 2015-10-15 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154891117 | Dorota Bozena Barton | Speech-Language Pathologist | 2121 Ne 139th Street Mob A, Suite 200, Vancouver, WA 98686 | 2018-12-03 |
| 1881161818 | Michelle Wolfe | Dental Assistant | A101, 1484, 14313 Ne 20th Ave, Vancouver, WA 98686 | 2018-10-29 |
| 1306321237 | Rainier Springs Physician Group, LLC | General Practice | 2805 Ne 129th Street, Vancouver, WA 98686 | 2018-09-26 |
| 1801382387 | Kristopher K Kostenko | Dentist | 14201 Ne 20th Ave Ste A101, Vancouver, WA 98686 | 2018-07-08 |
| 1689164071 | Tegan Mills | Occupational Therapist | 7101 Ne 109th Street, Apt 64, Vancouver, WA 98686 | 2018-05-11 |
| 1164924122 | Kate Kristin Lawrence | Speech-Language Pathologist | 2215 Ne 104th St, Vancouver, WA 98686 | 2018-03-06 |
| 1437609567 | Elina Baranets | Registered Nurse | 14204 Ne Salmon Creek Avenue, Vancouver, WA 98686 | 2016-10-13 |
| 1386039550 | Sean Vikram Bhatia | Internal Medicine | Kaiser Salmon Creek, 14406 Ne 20th Ave, Vancouver, WA 98686 | 2015-04-03 |
| 1376988642 | Lindsay Hussey-andersen | Orthopaedic Surgery | 2525 Ne 139th St Ste 140, Vancouver, WA 98686 | 2013-05-01 |
| 1710253109 | Legacy Salmon Creek Hospital | Speech-Language Pathologist | 2121 Ne 139th St., Mob A, Ste 200, Vancouver, WA 98686 | 2012-03-29 |
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| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265527535 | Emergency and Acute Care Medical Company - Northwest, Inc. | Emergency Medicine | Legacy Salmon Creek Hospital, 2211 Ne 139th Street, Vancouver, WA 98686 | 2006-10-04 |
| 1538114988 | Anita Joy Demlow | Emergency Medicine | 700 Ne 87th Ave Ste 110, Vancouver, WA 98664-1913 | 2006-05-24 |
| 1962460576 | Heather Schalon | Emergency Medicine | 600 Ne 92nd Ave, Vancouver, WA 98664-3225 | 2006-05-03 |
| 1831175462 | Carolyn Johanna Martin | Emergency Medicine | 400 Ne Mother Joesph Place, Vancouver, WA 98664 | 2005-12-15 |
| 1053653295 | Jamie Mcginnity | Emergency Medicine | 2211 Ne 139th St, Vancouver, WA 98686 | 2013-03-26 |
| 1023370293 | Megumi S Ketcham | Emergency Medicine | 2211 Ne 139th St, Vancouver, WA 98686-2742 | 2012-06-13 |
| 1689934218 | Shwetha Veera Hareesh | Emergency Medicine | 700 Ne 87th Ave Ste 110, Vancouver, WA 98664 | 2012-05-16 |
| 1710278023 | Eric D Ferraris | Emergency Medicine | 600 Ne 92nd Ave, Emergency Department, Vancouver, WA 98664-3225 | 2011-04-21 |
| 1285924217 | Tam Tri Vuong | Emergency Medicine | 2211 Ne 139th St, Vancouver, WA 98686-2742 | 2011-04-11 |
| 1013150192 | Erin Meadows | Emergency Medicine | 2211 Ne 139th St, Vancouver, WA 98686-2742 | 2009-04-20 |
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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.