THEODORE A WAGNER (NPI# 1811077894) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811077894 |
| Entity Type | Individual |
| Full Name | THEODORE A WAGNER |
| Credential | MD |
| Practice Address |
Uwmc-roosevelt 4245 Roosevelt Way Ne Seattle WA 98105-4740 |
| Mailing Address |
Po Box 50095 Seattle WA 98145-5095 |
| Practice Telephone | 2065984288 |
| Mailing Telephone | 2065436420 |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2011-09-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207X00000X | Orthopaedic Surgery | MD00011315 | WA | Allopathic & Osteopathic Physicians |
| Y | 207XS0117X |
Orthopaedic Surgery Specialization: Orthopaedic Surgery of the Spine |
MD00011315 | WA | Allopathic & Osteopathic Physicians |
| N | 207XP3100X |
Orthopaedic Surgery Specialization: Pediatric Orthopaedic Surgery |
MD00011315 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | L&I | 0232121 | 01 |
| INTERNAL ID-MOTOR VEHICLE ID | 9054 | 01 | |
| WA | 1811077894 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831162791 | Theodore T Wagner | Urology | 2512 E Dupont Rd, Ste. 100, Fort Wayne, IN 46825-1675 | 2006-02-10 |
| Street Address |
UWMC-ROOSEVELT 4245 ROOSEVELT WAY NE |
| City | SEATTLE |
| State | WA |
| Zip Code | 98105-4740 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649350612 | Brenda Sue Houmard | Obstetrics & Gynecology | Uwmc-roosevelt, 4245 Roosevelt Way Ne, Seattle, WA 98105-4765 | 2006-10-16 |
| 1578606042 | Sharon Ann Dobie | Family Medicine | Uwmc-roosevelt, 4245 Roosevelt Way Ne, Seattle, WA 98105-4770 | 2007-02-15 |
| 1487797957 | Lynn M Oliver | Family Medicine | Uwmc-roosevelt, 4245 Roosevelt Way Ne, Seattle, WA 98105-4770 | 2007-02-15 |
| 1679630875 | Julia R Heiman | Psychologist | Uwmc-roosevelt, 4225 Roosevelt Way Ne, Suite 306, Seattle, WA 98105-4794 | 2007-01-03 |
| 1538248299 | Amy Lee Vanblaricom | Obstetrics & Gynecology | Uwmc-roosevelt, 4245 Roosevelt Way Ne, Seattle, WA 98105-4765 | 2006-11-03 |
| 1003992371 | Anne-marie Elizabeth Amies Oelschlager | Obstetrics & Gynecology | Uwmc-roosevelt, 4245 Roosevelt Way Ne, Seattle, WA 98105-4765 | 2006-10-30 |
| 1720164577 | Anne Marie Eacker | Internal Medicine | Uwmc-roosevelt, 4245 Roosevelt Way Ne, Seattle, WA 98105-6920 | 2006-10-27 |
| 1659457463 | Kristina Maria Adams Waldorf | Obstetrics & Gynecology | Uwmc-roosevelt, 4245 Roosevelt Way Ne, Seattle, WA 98105-4765 | 2006-10-27 |
| 1891871612 | Stanley L Hurst | Dermatology | Uwmc-roosevelt, 4225 Roosevelt Way Ne, Seattle, WA 98105-6166 | 2006-10-27 |
| 1649356361 | Viksa Mendiratta | Obstetrics & Gynecology | Uwmc-roosevelt, 4245 Roosevelt Way Ne, Seattle, WA 98105-4765 | 2006-10-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326662396 | Dale Justin Podolsky | Student in an Organized Health Care Education/Training Program | 4800 Sand Point Way Ne, Ob.9.520, Seattle Children's, Seattle, WA 98105 | 2020-06-04 |
| 1376170878 | Andrew Crompton Yazman | Pediatrics | 4800 Sand Point Way, Ne Oc.7.830, Seattle, WA 98105 | 2020-03-25 |
| 1427688845 | Daniela Michell Zepeda | Behavioral Analyst | 4616 25th Ave Ne Pmb 437, Seattle, WA 98105 | 2020-01-24 |
| 1255981189 | Emily King | Student in an Organized Health Care Education/Training Program | Mark Hawkins, Pa-c, Mpas, 4311 11th Ave Ne Suite 200, WA 98105 | 2019-09-12 |
| 1821659327 | Sara Katherine Horne | Student in an Organized Health Care Education/Training Program | 4800 Sand Point Way Ne, Mb.11.500, Department of Anesthesiology and Pain Medicine, Seattle, Seattle, WA 98105 | 2019-06-25 |
| 1881252575 | Darryl Lee Wright | Peer Specialist | Gossett Place, 4719 12th Ave Ne, Seattle, WA 98105 | 2019-05-29 |
| 1487117891 | Nirupama Madhavan | Behavioral Analyst | 5001 25th Ave Ne, Seattle, WA 98105 | 2019-04-11 |
| 1780155648 | Eryn R Mcentee | Naturopath | 2216 Ne46th St, Seattle, WA 98105 | 2018-12-17 |
| 1356811921 | Kyle Leland Bernbach | Massage Therapist | 5224 Ravenna Ave Ne, Seattle, WA 98105 | 2018-11-27 |
| 1548742380 | Janal Kim | Physician Assistant | 4726 11th Ave Ne, Apt 511, Seattle, WA 98105 | 2018-08-29 |
| Find all providers in zip 98105 | ||||
| Taxonomy Code | 207XS0117X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Orthopaedic Surgery of the Spine |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic surgeons of the spine deal with the evaluation and nonoperative and operative treatment of the full spectrum of primary spinal disorders including trauma, degenerative, deformity, tumor, and reconstructive. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447298021 | Paul Edward Schwaegler | Orthopaedic Surgery | 550 16th Ave Ste 404, Seattle, WA 98122-5636 | 2006-06-03 |
| 1699328278 | Bilal Izzat Qutteineh | Orthopaedic Surgery | 550 17th Ave Ste 500, Seattle, WA 98122-5789 | 2019-07-22 |
| 1063924116 | Proliance Surgeons, Inc., P.s | Orthopaedic Surgery | 801 Broadway Ste 617, Seattle, WA 98122-4319 | 2017-10-30 |
| 1790203255 | Julianne V. Krause | Orthopaedic Surgery | 1959 Ne Pacific St, Seattle, WA 98195-0001 | 2017-09-05 |
| 1417470345 | Ronen Blecher | Orthopaedic Surgery | 500 17th Ave, Seattle, WA 98122-5711 | 2017-07-23 |
| 1942741715 | Nilay Chhasatia | Orthopaedic Surgery | 1100 9th Ave, G1-mso, Seattle, WA 98101-2756 | 2017-03-14 |
| 1609137504 | Nathan Andrew Wigner | Orthopaedic Surgery | 908 Jefferson St, Seattle, WA 98104-2433 | 2012-06-06 |
| 1265708929 | David Gendelberg | Orthopaedic Surgery | 908 Jefferson St, Seattle, WA 98104-2433 | 2012-03-27 |
| 1154609337 | Farhan Omar Karim | Orthopaedic Surgery | 908 Jefferson St, Seattle, WA 98104-2433 | 2011-07-22 |
| 1053600742 | Christina W Cheng | Orthopaedic Surgery | 908 Jefferson St, Seattle, WA 98104-2433 | 2011-04-04 |
| Find all providers in SEATTLE | ||||
Please comment or provide details below to improve the information on THEODORE A WAGNER.
| 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.