Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Glavis M Wagner

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1720587553

Glavis M Wagner is an Addiction (Substance Use Disorder) Counselor in Pendleton, Oregon. Licensed in Oregon. Registered with an NPI since 2018.

Licensed in
OR
In the registry since
2018
Specialties on file
3

Practice location Address checks out

46314 Timine Way
Pendleton, OR 97801
Phone: (541) 966-9830
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Prevention Professional (primary) Taxonomy 405300000X · Licence 17-CRM-217 (OR)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence 17-CRM-217 (OR)
Peer Specialist Taxonomy 175T00000X · Licence THW000002415 (OR)

Record details

NPI number1720587553
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedFebruary 7, 2018
Last updated in NPPESJuly 23, 2020
Certification dateJuly 23, 2020
Mailing address46314 Timine Way, Pendleton, OR 97801-9417

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