MR. ERIC MARTIN WAGNER (NPI# 1770856106) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770856106 |
| Entity Type | Individual |
| Full Name | MR. ERIC MARTIN WAGNER |
| Credential | PA-C |
| Practice Address |
Madigan Army Medical Center 9040 Jackson Ave Tacoma WA 98431-0001 |
| Practice Telephone | 2539683744 |
| Enumeration Date | 2012-02-15 |
| Last Update Date | 2019-12-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316474083 | Eric Jameson Wagner | Student in an Organized Health Care Education/Training Program | 1331 Moursund Ave., Bldg. G Rm 115-118, Houston, TX 77030-5389 | 2017-05-12 |
| 1619263241 | Eric R Wagner | Orthopaedic Surgery | 59 Executive Park S Ste 2000, Atlanta, GA 30329-2208 | 2011-06-22 |
| 1326009143 | Eric John Wagner | Dentist | 112 2nd Ave Nw, Hampton, IA 50441-1724 | 2006-03-31 |
| 1083222905 | Eric Wagner | Massage Therapist | 2462 W 3rd St, Santa Rosa, CA 95401-6425 | 2020-07-16 |
| 1306312012 | Eric Wagner | Behavior Technician | 2818 N Ralph Ave, Tucson, AZ 85712-1635 | 2018-10-19 |
| 1306358445 | Eric David Wagner | Nurse Anesthetist, Certified Registered | 405 W Jackson St, Carbondale, IL 62901-1462 | 2017-10-30 |
| 1487043196 | Eric Wagner | Licensed Practical Nurse | 526 W Main St, Sparta, WI 54656-2146 | 2015-01-19 |
| 1043563323 | Eric Michael Wagner | Pharmacist | 110 Southside Blvd, Dillon, MT 59725-3536 | 2012-10-23 |
| 1528319365 | Eric Bruce Wagner | Pharmacist | 330 Lebby St, Pelzer, SC 29669-1758 | 2012-09-19 |
| 1477875078 | Eric N Wagner | Hearing Instrument Specialist | 218 W Market St, Ste7, Charlottesville, VA 22902-5061 | 2010-02-23 |
| Street Address |
MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE |
| City | TACOMA |
| State | WA |
| Zip Code | 98431-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396740254 | Dennis Huang | Podiatrist | Madigan Army Medical Center 9040 Jackson Ave, Tacoma, WA 98431-0001 | 2005-06-16 |
| 1891395851 | Juliana Dumayas | Registered Nurse | Madigan Army Medical Center 9040 Jackson Ave, Tacoma, WA 98431-0002 | 2020-10-29 |
| 1922658491 | Fatima Hossay Safi | Social Worker | Madigan Army Medical Center 9040 Jackson Ave, Tacoma, WA 98431-0001 | 2019-09-17 |
| 1134778095 | Vinzuella Boddie | Registered Nurse | Madigan Army Medical Center 9040 Jackson Ave, Tacoma, WA 98431-0001 | 2019-09-04 |
| 1588219059 | Susan Marie Lopez | Dietitian, Registered | Madigan Army Medical Center 9040 Jackson Ave, Tacoma, WA 98431-0001 | 2019-08-01 |
| 1174177109 | Bradley Scott Miller | Registered Nurse | Madigan Army Medical Center 9040 Jackson Ave, Tacoma, WA 98431-1100 | 2019-07-29 |
| 1437703568 | Alex Alberto Hernandez Vargas | Registered Nurse | Madigan Army Medical Center 9040 Jackson Ave, Tacoma, WA 98431-0001 | 2019-07-26 |
| 1427619733 | Dana Michelle Sanchez-terry | Nurse Practitioner | Madigan Army Medical Center 9040 Jackson Ave, Tacoma, WA 98431 | 2019-06-26 |
| 1255998076 | Scott Michael Brown | Military Health Care Provider | Madigan Army Medical Center 9040 Jackson Ave, Tacoma, WA 98431-5650 | 2019-05-28 |
| 1861059081 | Nathaniel Alan Castonguay | Licensed Practical Nurse | Madigan Army Medical Center 9040 Jackson Ave, Tacoma, WA 98431-1100 | 2019-05-22 |
| 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 | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609486026 | Joanna Christine Hope | Physician Assistant | 2502 S Union Avenue, Tacoma, WA 98405 | 2020-08-01 |
| 1831663442 | Noah C Chance | Physician Assistant | 9040 Jackson Ave Attn:credentials, Tacoma, WA 98431-4604 | 2019-01-16 |
| 1336618040 | Bailey Bangerter | Physician Assistant | 1901 South Union, A-233, Tacoma, WA 98405 | 2018-11-26 |
| 1518448539 | Kimberly Bui | Physician Assistant | 112 S 8th St Ste 200, Tacoma, WA 98402-5294 | 2018-08-27 |
| 1568942621 | Michelle Lynn Scott | Physician Assistant | 1201 Pacific Ave Ste C6, Tacoma, WA 98402-4393 | 2018-08-17 |
| 1548770670 | Bradley Richard Poe | Physician Assistant | 209 M.l.k. Jr Way, Tacoma, WA 98405 | 2017-10-03 |
| 1326588369 | Alyssa K. Leaning | Physician Assistant | 1724 W Union Ave Ste 100, Tacoma, WA 98405-2099 | 2017-02-23 |
| 1356609218 | Rebecca Ann Sciandra | Physician Assistant | 9040a Jackson Ave Madigan Army Medical Center, Tacoma, WA 98431-7037 | 2012-04-30 |
| 1023392529 | Kristie Michelle Mattern | Physician Assistant | 5427 S Birmingham St, Tacoma, WA 98409-5417 | 2011-10-03 |
| 1700100385 | Colleen Anne Carette | Physician Assistant | 1500 N. Warner St., #1035, Tacoma, WA 98416-1035 | 2010-03-25 |
| 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.