Glavis M. Wagner

Prevention Professional · Pendleton, OR

Individual Active NPI

NPI number 1720587553

Practice location

46314 Timine Way
Pendleton, OR 97801
Phone
(541) 966-9830

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NPI record

NPI
1720587553
Entity type
Individual (Type 1)
Enumeration date
February 7, 2018
Last updated
July 23, 2020
Certified
July 23, 2020
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Prevention Professional Primary 405300000X 17-CRM-217 OR
Addiction (Substance Use Disorder) Counselor 101YA0400X 17-CRM-217 OR
Peer Specialist 175T00000X THW000002415 OR

Mailing address

46314 Timine Way
Pendleton, OR 97801-9417
Phone
(541) 966-9830
Fax
(541) 278-7568

About Glavis Wagner

Glavis M. Wagner is a healthcare provider registered in the NPI registry with the primary taxonomy Prevention Professional (code 405300000X). The practice location is 46314 Timine Way, Pendleton, OR 97801. The NPI number 1720587553 was assigned on February 7, 2018 and the record was last updated on July 23, 2020.

Glavis Wagner lists 3 licenses in the registry: #17-CRM-217 (OR) for Prevention Professional; #17-CRM-217 (OR) for Addiction (Substance Use Disorder) Counselor; #THW000002415 (OR) for Peer Specialist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Glavis M. Wagner?

The NPI number is 1720587553.

What is the phone number of Glavis Wagner?

The phone number listed for the practice location is (541) 966-9830.

Where is Glavis Wagner located?

46314 Timine Way, Pendleton, OR 97801.

What is the taxonomy code for Glavis Wagner?

The primary taxonomy code is 405300000X – Prevention Professional; 2 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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