AMANDA WAGER (NPI# 1891242913) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891242913 |
| Entity Type | Individual |
| Full Name | AMANDA WAGER |
| Credential | MSW, MHP |
| Practice Address |
204 Ne 94th Street Seattle WA 98115-2727 |
| Mailing Address |
15622 36th Ave Ne Lake Forest Park WA 98155-6616 |
| Practice Telephone | 2064614580 |
| Enumeration Date | 2016-09-07 |
| Last Update Date | 2016-09-07 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities |
| Street Address |
204 NE 94TH STREET |
| City | SEATTLE |
| State | WA |
| Zip Code | 98115-2727 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366079972 | Aaron Hui | Oral & Maxillofacial Surgery | 6222 Ne 74th Street Building 25, 2nd Floor, Seattle, WA 98115 | 2020-03-24 |
| 1396387346 | Catherine Erickson | Social Worker | 6527 - 21st Ave Ne, Suite 4, Seattle, WA 98115 | 2019-10-10 |
| 1275003857 | Margaret Ellen Haber | Social Worker | 2400 Ne 95th Street, Seattle, WA 98115 | 2018-11-27 |
| 1528584513 | Katharine Huntington Poinier | Registered Nurse | 8521 5th Avenue Ne, Seattle, WA 98115 | 2017-08-21 |
| 1750802229 | Cody David Pollock | Student in an Organized Health Care Education/Training Program | 1959 Northeast Pacific Street, Box 357115 University of Washington Medical Center, Seattle, WA 98115 | 2017-07-05 |
| 1144759416 | Amber Padron | Behavior Technician | 6537 Oswego Place Ne, Apt 8, Seattle, WA 98115 | 2017-06-08 |
| 1639603509 | Matthew Vanwinkle | Physical Therapist | 3290 Ne 65th Street, Unit 101, Seattle, WA 98115 | 2017-04-17 |
| 1538607650 | Karen Van Vuren | Registered Nurse | 204 Ne 94h St, Seattle, WA 98115 | 2017-02-09 |
| 1992251599 | Anders Kobbevik | Massage Therapist | 1200 Ne 65th Street, Seattle, WA 98115 | 2016-09-01 |
| 1295288181 | Brandon Marsicek | Counselor | 419 Ne 71st St Apt 407, Seattle, WA 98115 | 2016-07-27 |
| Find all providers in zip 98115 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750923280 | Sound | Community Based Residential Treatment Facility, Mental Illness | 3515 Woodland Park Ave N, Seattle, WA 98103-8928 | 2019-10-16 |
| 1922640457 | Sound | Community Based Residential Treatment Facility, Mental Illness | 2119 2nd Ave, Seattle, WA 98121-2207 | 2019-10-16 |
| 1225670755 | Sound | Community Based Residential Treatment Facility, Mental Illness | 204 Ne 94th St, Seattle, WA 98115-2752 | 2019-10-16 |
| 1699150771 | Terran Imani Poindexter | Community Based Residential Treatment Facility, Mental Illness | 2600 Sw Holden St, Seattle, WA 98126-3505 | 2015-07-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851885107 | Comprehensive Healthcare | Community Based Residential Treatment Facility, Mental Illness | 1250 Se Commercial Dr, College Place, WA 99324 | 2018-06-20 |
| 1801240361 | Alyssia Lucas | Community Based Residential Treatment Facility, Mental Illness | 6510 Cady Rd, Everett, WA 98203-4520 | 2016-04-20 |
| 1821459041 | Cullum House | Community Based Residential Treatment Facility, Mental Illness | 208 Cullum Ave, Richland, WA 99352-4534 | 2016-03-16 |
| 1720470057 | Metropolitan Development Council | Community Based Residential Treatment Facility, Mental Illness | 721 Fawcett Ave Ste 100, Tacoma, WA 98402-5502 | 2015-02-24 |
| 1083035547 | Comprehensive Healthcare | Community Based Residential Treatment Facility, Mental Illness | 201 S 2nd Ave, Yakima, WA 98902 | 2013-12-30 |
| 1801224803 | The Clearing, Spc | Community Based Residential Treatment Facility, Mental Illness | 2687 W Valley Rd, Friday Harbor, WA 98250-8164 | 2013-10-29 |
| 1952532996 | Behavioral Health Resources | Community Based Residential Treatment Facility, Mental Illness | 1275 S 2nd Ave Sw, Tumwater, WA 98512-6976 | 2009-08-06 |
| 1447481858 | Elahan Place | Community Based Residential Treatment Facility, Mental Illness | 7415 Ne 94th Ave, Vancouver, WA 98662-3859 | 2009-08-03 |
| 1689812968 | Comprehensive Healthcare | Community Based Residential Treatment Facility, Mental Illness | 504 S 3rd Ave, Yakima, WA 98902 | 2009-01-26 |
| 1730302811 | On Good Hands Afh LLC | Community Based Residential Treatment Facility, Mental Illness | 508 172nd Pl Ne, Bellevue, WA 98008-4127 | 2007-04-10 |
| 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.