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

Samuel Russell Waggoner

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1316658974

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 St
Portland, OR 97232-3159
Phone: (503) 238-5203
Show map & directions

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 number1316658974
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedDecember 5, 2022
Last updated in NPPESDecember 5, 2022
Certification dateDecember 5, 2022

Other providers in Portland