GLAVIS WAGNER

Prevention Professional

Active Individual
NPI: 1720587553

Practice Address

46314 TIMINE WAY
Pendleton, OR 97801

Phone: (541) 966-9830

Specialties

Specialty Code Primary License
Counselor - Addiction (Substance Use Disorder) 101YA0400X No 17-CRM-217 (OR)
Peer Specialist 175T00000X No THW000002415 (OR)
Prevention Professional 405300000X Yes 17-CRM-217 (OR)

Frequently Asked Questions

NPI 1720587553 is the National Provider Identifier for GLAVIS WAGNER, a Prevention Professional provider located in Pendleton, OR. This NPI was enumerated on February 7, 2018.
GLAVIS WAGNER practices at 46314 TIMINE WAY, Pendleton, OR 97801.

Quick Facts

NPI
1720587553
Type
Individual
Enumerated
Feb 7, 2018
Last Updated
Jul 23, 2020

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