DR. JOHN W. WAGGONER III (NPI# 1922053016) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1922053016 |
Entity Type | Individual |
Full Name | DR. JOHN W. WAGGONER III |
Credential | M.D. |
Practice Address |
500 Lilly Rd Ne Suite 100 Olympia WA 98506-5195 |
Practice Telephone | 3604135825 |
Practice Fax Number | 3604138837 |
Mailing Telephone | 3604135825 |
Mailing Fax Number | 3604138837 |
Enumeration Date | 2006-05-24 |
Last Update Date | 2017-06-12 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
MD00046169 | WA | Allopathic & Osteopathic Physicians |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730354986 | John Craig Waggoner | Pharmacist | 510 Coronado St, Bonner Springs, KS 66012-1203 | 2008-04-29 |
1699336867 | John Ross Waggoner | Behavior Technician | 8000 West End Road, Anchorage, AK 99501 | 2019-06-27 |
1104320076 | John P Waggoner | Orthopaedic Surgery | 34800 Bob Wilson Dr, San Diego, CA 92134-1098 | 2018-03-23 |
1255779922 | John Hastings Waggoner | Physical Therapist | 2005 Avalon Ave, Muscle Shoals, AL 35661-3188 | 2013-06-04 |
1013352194 | John Robert Waggoner Jr. | Counselor | 4455 E 12th Ave, Denver, CO 80220-2415 | 2013-05-03 |
1710040886 | John Wesley Waggoner | Clinical Neuropsychologist | 2200 Bergquist Dr, 59 Mhs/sgowmp - Neuropsychology, 4th Floor, Lackland A F B, TX 78236-9907 | 2006-12-19 |
Street Address |
500 LILLY RD NE SUITE 100 |
City | OLYMPIA |
State | WA |
Zip Code | 98506-5195 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1871594325 | David H Schoening | Internal Medicine | 500 Lilly Rd Ne, Ste 100, Olympia, WA 98506 | 2005-08-09 |
1720644073 | Carol Neff Moreno | Family Medicine | 500 Lilly Rd Ne, Olympia, WA 98506-5195 | 2019-05-13 |
1770936015 | Ester Monique Brown | Licensed Practical Nurse | 500 Lilly Rd Ne, Olympia, WA 98506-5195 | 2016-07-22 |
1073969101 | Samantha Moore | Physician Assistant | 500 Lilly Rd Ne, Olympia, WA 98506-5195 | 2016-05-07 |
1467720292 | Sarah Byram Poppe | Nurse Practitioner | 500 Lilly Rd Ne, Suite 204, Olympia, WA 98506-5197 | 2011-12-07 |
1164724308 | Providence Health & Services-washington | Internal Medicine | 500 Lilly Rd Ne, Suite 100, Olympia, WA 98506-5195 | 2010-11-20 |
1659554624 | Scott David Werden | Internal Medicine | 500 Lilly Rd Ne, Memorial Medical Plaza, Olympia, WA 98506-5195 | 2007-12-12 |
1124144431 | Elijah Telfare | Physician Assistant | 500 Lilly Rd Ne, Suite 100, Olympia, WA 98506-5195 | 2007-03-21 |
1194867887 | Northwest Radiology Group LLC | Specialist | 500 Lilly Rd Ne, Suite 160, Olympia, WA 98506-5195 | 2007-02-12 |
1245391390 | Patrick C Williams | Physician Assistant | 500 Lilly Rd Ne, Suite 204, Olympia, WA 98506-5197 | 2006-12-13 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477185460 | Chloe Harper | Technician, Other | 3443 Lilly Rd Se, Ste B, Olympia, WA 98506 | 2020-02-07 |
1912543539 | Jessica Marie Radakovich | Licensed Practical Nurse | 3426 Mary Elder Rd, Olympia, WA 98506 | 2019-11-19 |
1669014973 | Arlene Josephine Adams | Registered Nurse | 413 Lily Rd Ne, Olympia, WA 98506 | 2019-10-09 |
1861999120 | Debra Delores Barker | Licensed Practical Nurse | 3710 South Bay Rd Ne, Olympia, WA 98506 | 2018-04-12 |
1801304431 | Michelle Warner | Nurse Practitioner | 205 Lilly Rd Ne Ste A1, Olympia, WA 98506 | 2018-01-17 |
1396258364 | Institute for Family Development | Community/Behavioral Health | 204 Quince St. Ne, Suite 200, Olympia, WA 98506 | 2017-11-13 |
1083137715 | Cameron Kunkel | Specialist/Technologist | 2512 20th Ave Ne, Olympia, WA 98506 | 2017-07-25 |
1184144768 | Trevor Shane Kwan | Family Medicine | 525 Lilly Road Ne, Olympia, WA 98506 | 2017-06-23 |
1073043212 | Michael H Harburg | Behavior Technician | 3857 Martin Way Ne, Olympia, WA 98506 | 2017-06-19 |
1780114371 | Priscilla Kangyang Jadu | Counselor | 3857 Martin Way E., Olympia, WA 98506 | 2017-06-15 |
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Taxonomy Code | 207RI0011X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Interventional Cardiology |
An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1811225923 | Gopal Ghimire | Internal Medicine | 500 Lilly Rd Ne Ste 100, Providence Cardiology Associates, Olympia, WA 98506-5195 | 2009-12-01 |
1609081330 | Adam Kendall Dunn | Internal Medicine | 406 Black Hills Ln Sw Ste A, Olympia, WA 98502-8144 | 2007-05-14 |
1447363734 | Jimmy Zhuang Swan | Internal Medicine | 500 Lilly Rd Ne, Suire 100, Olympia, WA 98506-5195 | 2006-08-17 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982905923 | J. Randall Farrar, Md | Internal Medicine | 1155 Jadwin Ave, Richland, WA 99352-3434 | 2010-11-08 |
1679522106 | Inland Cardiology Associates, P.s. | Internal Medicine | 122 West 7th Avenue, Suite 450, Spokane, WA 99204-4332 | 2006-05-10 |
1871986455 | Sunnyside Community Hospital Association | Internal Medicine | 812 Miller Ave, Sunnyside, WA 98944-2374 | 2015-03-06 |
1568892586 | Shenjing Li | Internal Medicine | 200 Ne Mother Joseph Pl Ste 400, Vancouver, WA 98664-3290 | 2013-11-13 |
1023389061 | Henry Chu | Internal Medicine | 700 Ne 87th Ave Ste 210, Vancouver, WA 98664 | 2012-01-23 |
1225311756 | Danny Dvir | Internal Medicine | 1959 Ne Pacific St, Seattle, WA 98195-0001 | 2011-09-21 |
1841510310 | Kenta Nakamura | Internal Medicine | 1959 Ne Pacific St, Seattle, WA 98195-0001 | 2010-06-08 |
1588989032 | Patrick John Goleski | Internal Medicine | 1959 Ne Pacific St, Seattle, WA 98195-0001 | 2010-03-27 |
1508196833 | Jacob Appel Doll | Internal Medicine | 1959 Ne Pacific St, Seattle, WA 98195-0001 | 2010-01-08 |
1073743373 | Liam Anthony Morris | Internal Medicine | 1201 S Miller St, Wenatchee, WA 98801-3201 | 2009-07-21 |
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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.