Wagner, Glavis M

Wagner, Glavis M is an individual health care provider with primary practice located at 46314 Timine Way , Pendleton OR 97801. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Other Service Providers / Peer Specialist, Other Service Providers / Prevention Professional. Other Service Providers / Prevention Professional is his primary health care specialty. Wagner, Glavis M can be contacted via phone (541) 966-9830.

Contact Information

Primary practice address
46314 Timine Way Pendleton OR 97801
Phone: (541) 966-9830
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 17-CRM-217 Oregon
Other Service Providers / Peer Specialist 175T00000X THW000002415 Oregon
Other Service Providers / Prevention Professional 405300000X 17-CRM-217 Oregon

Profile Details

NPI number 1720587553
LBN Legal business name Wagner, Glavis M
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 7th, 2018
Last updated Jul 23rd, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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