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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

GLAVIS M WAGNER

Active

GLAVIS M WAGNER is a 405300000X healthcare provider located in PENDLETON, Oregon. NPI 1720587553 is currently active in the NPPES registry. Verify at CMS.

405300000X · PENDLETON, OR

Registration Details

NPI Number
1720587553
Provider Type
Individual
Gender
Male
NPI Issued
Feb 7, 2018 (8.4900142848993 yrs)
Last Updated
Jul 23, 2020
Licenses
17-CRM-217 (OR)
THW000002415 (OR)
17-CRM-217 (OR)

Practice Information

Address
46314 TIMINE WAY
PENDLETON, OR, 97801
Browse OR providers · Browse ZIP 97801
Phone
5419669830
Primary Specialty
405300000X
405300000X
Additional Specialty
Peer Specialist
Additional Specialty
405300000X

Other 405300000X Providers in PENDLETON, OR

Name Credential NPI
ABELARDO LOZANO CRM 1750864229
RACHEL MARIE HOPTOWIT CRM 1629687876
NICOLE GRACE WHISKEYJACK CRM 1841809134
VIVIAN JUNE SHAW CRM 1205446663
LEEANN MASHAUNA SMITH CRM 1508459579
MS. SARAH JEAN FRANK 1205411444
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.