Samuel Russell Waggoner
Samuel Russell Waggoner is an Addiction (Substance Use Disorder) Counselor in Portland, Oregon. Licensed in Oregon. Registered with an NPI since 2022.
- Licensed in
- OR
- In the registry since
- 2022
Practice location Address checks out
2727 NE Flanders StPortland, OR 97232-3159
Phone: (503) 238-5203
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Addiction (Substance Use Disorder) Counselor (primary) | Taxonomy 101YA0400X · Licence T-22-1492 (OR) |
|---|
Record details
| NPI number | 1316658974 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | December 5, 2022 |
| Last updated in NPPES | December 5, 2022 |
| Certification date | December 5, 2022 |
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