Provider Demographics
NPI:1801436480
Name:MEGAN WAGONER PSYD PLLC
Entity type:Organization
Organization Name:MEGAN WAGONER PSYD PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:WAGONER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:360-513-1888
Mailing Address - Street 1:4860 RAINIER AVE S STE C
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-6305
Mailing Address - Country:US
Mailing Address - Phone:360-513-1888
Mailing Address - Fax:888-797-7376
Practice Address - Street 1:4860 RAINIER AVE S STE C
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-6305
Practice Address - Country:US
Practice Address - Phone:360-513-1888
Practice Address - Fax:888-797-7376
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-10
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty