MS. SHIRLEY G WAGONER (NPI# 1659479723) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659479723 |
| Entity Type | Individual |
| Full Name | MS. SHIRLEY G WAGONER |
| Credential | ARNP |
| Practice Address |
208 Cedar Creek Terrace Ione WA 99139-0197 |
| Mailing Address |
Po Box 197 Ione WA 99139-0197 |
| Practice Telephone | 5094423514 |
| Practice Fax Number | 5094423436 |
| Mailing Telephone | 5094423514 |
| Mailing Fax Number | 5094423436 |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2015-05-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
AP60007062 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LW0102X |
Nurse Practitioner Specialization: Women's Health |
AP60007062 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 367A00000X | Advanced Practice Midwife | AP30001501 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
208 CEDAR CREEK TERRACE |
| City | IONE |
| State | WA |
| Zip Code | 99139-0197 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912961822 | New Health Programs Association | Clinic/Center | 208 Cedar Creek Terrace, Ione, WA 99139 | 2006-04-17 |
| 1467603266 | Joseph D Petersen | Nurse Practitioner | 208 Cedar Creek Terrace, Ione, WA 99139 | 2008-10-10 |
| 1811030323 | Richard G Calef | Physician Assistant | 208 Cedar Creek Terrace, Ione, WA 99139 | 2007-02-14 |
| 1427139583 | Joseph Sterling Taylor | Family Medicine | 208 Cedar Creek Terrace, Box 197, Ione, WA 99139 | 2006-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336352962 | Belinda Elaine Russo | Massage Therapist | 222 Sunset Dr. S., Ione, WA 99139 | 2007-05-08 |
| 1356886998 | Kevin Doerr Sullivan | Physician Assistant | 208 Cedar Creek Ter, Ione, WA 99139-5011 | 2017-01-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861032286 | Emily Campbell | Doula | 3454 Flint Trl, Ione, CA 95640-9679 | 2020-01-14 |
| 1982185476 | Carol Sundell | Licensed Vocational Nurse | 325 S Sacramento St, Ione, CA 95640-9172 | 2018-08-23 |
| 1316423692 | Millie Georganna Herrera | Psychologist | 4001 State Higheay 104, Ione, CA 95640 | 2018-07-19 |
| 1861932378 | Dawn Kettell-ness | Registered Nurse | 2000 Camanche Rd Spc 54, Ione, CA 95640-9427 | 2017-03-02 |
| 1356886998 | Kevin Doerr Sullivan | Physician Assistant | 208 Cedar Creek Ter, Ione, WA 99139-5011 | 2017-01-05 |
| 1952750663 | Deborah Jo Smith | Marriage & Family Therapist | 1400 W Marlette St Spc 17, Ione, CA 95640-9517 | 2016-06-03 |
| 1033578968 | Hector Duran Flores | Non-emergency Medical Transport (VAN) | 3495 Lakeview Dr, Ione, CA 95640-9613 | 2016-02-20 |
| 1134598295 | O. M. Custer | Psychologist | 14 West Main St, Suite 5, Ione, CA 95640-1415 | 2015-09-18 |
| 1538542832 | Wendy Sober | Marriage & Family Therapist | 813 Dove Ln, Ione, CA 95640-9203 | 2015-07-06 |
| 1477945517 | Morrow County Health District | Clinic/Center | 365 W 3rd St, Ione, OR 97843-7216 | 2015-02-26 |
| Find all providers in IONE | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467603266 | Joseph D Petersen | Nurse Practitioner | 208 Cedar Creek Terrace, Ione, WA 99139 | 2008-10-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841802675 | Michelle Ann Rorie | Nurse Practitioner | 1100 Villanova St Ne, Olympia, WA 98516-5454 | 2020-08-22 |
| 1174132294 | Heather Catherine Pounds | Nurse Practitioner | 4222 Robin Rd W, University Place, WA 98466-1536 | 2020-07-24 |
| 1801410675 | Mi Thi Trieu Tran | Nurse Practitioner | 24611 116th Ave Se, Kent, WA 98030-4939 | 2020-06-08 |
| 1609409085 | Kris Dee Chatman | Nurse Practitioner | 1628 S Mildred St Ste 105, Tacoma, WA 98465-1628 | 2020-02-13 |
| 1912547365 | Thomas Lee Etherton | Nurse Practitioner | 4425 Cole Ct Se, Olympia, WA 98501-4474 | 2020-01-14 |
| 1306489760 | Nikolaus V Voswinkel | Nurse Practitioner | 1420 Terry Ave Unit 202, Seattle, WA 98101-1981 | 2019-10-17 |
| 1518509520 | Sasha Rose Jensen | Nurse Practitioner | 460 West G Street, Forks, WA 98331 | 2019-10-10 |
| 1306487772 | Harmony Kroll | Nurse Practitioner | 23475 225th Way Se, Ste 201, Maple Valley, WA 98038-5294 | 2019-10-07 |
| 1932751658 | Lesly Marie Dosono Barcena | Nurse Practitioner | 6700 Roosevelt Way Ne Apt A211, Seattle, WA 98115-6642 | 2019-07-12 |
| 1912568205 | Andrea Lyn Fellman | Nurse Practitioner | Ideal Option Clinic 328 South Stillaguamish Ave, Arlington, WA 98223-1660 | 2019-06-26 |
| Find all providers with the same taxonomy | ||||
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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.