Healthcare Provider Details

I. General information

NPI: 1801436480
Provider Name (Legal Business Name): MEGAN WAGONER PSYD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2020
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4860 RAINIER AVE S STE C
SEATTLE WA
98118-6305
US

IV. Provider business mailing address

1037 NE 65TH ST # 82845
SEATTLE WA
98115-6655
US

V. Phone/Fax

Practice location:
  • Phone: 360-513-1888
  • Fax: 888-797-7376
Mailing address:
  • Phone: 206-339-7327
  • Fax: 888-797-7376

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: MEGAN C WAGONER
Title or Position: SOLE OWNER
Credential: PSYD
Phone: 206-339-7327