Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1720587553 Individual Practitioner Male Practitioner

Glavis M Wagner

Prevention Professional • Pendleton, OR

Professional Overview & Biography Verified Profile Summary

Glavis Wagner is a registered healthcare professional specializing in Prevention Professional in Pendleton, OR. Practice services are available at 46314 TIMINE WAY under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

46314 Timine Way

Pendleton, OR 97801

Telephone 5419669830
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Prevention Professional in Pendleton, OR

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
13 Specialists

Practicing in Pendleton, OR (24 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2020-07-23
Prevention Professional Primary Specialty

NUCC Taxonomy Code: 405300000X

State License OR 17-CRM-217

Prevention Professionals work in programs aimed to address specific patient needs, such as suicide prevention, violence prevention, alcohol avoidance, drug avoidance, and tobacco prevention. The goal of the program is to reduce the risk of relapse, injury, or re-injury of the patient. Prevention Professionals work in a variety of settings and provide appropriate case management, mediation, referral, and mentorship services. Individuals complete prevention professionals training for the population of patients with whom they work.

Counselor - Addiction (Substance Use Disorder)

NUCC Taxonomy Code: 101YA0400X

State License OR 17-CRM-217

Definition to come...

Peer Specialist

NUCC Taxonomy Code: 175T00000X

State License OR THW000002415

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Cody Cimmiyotti

Peer Specialist

NPI 1003506429
NPI 1013107515

Doctor of Dental Medicine

Ian Sampson

Peer Specialist

NPI 1013403286
Amy Allen , RN

Registered Nurse

NPI 1013792696

Registered Nurse

Allan Jio

Pharmacist

NPI 1013928563
NPI 1033492822

Registered Pharmacist

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Practice Location July 10, 2018

Registered at 46314 TIMINE WAY, PENDLETON, OR 97801 (Tel: 5419669830)

📍
Updated Practice Location April 24, 2018

Registered at 46314 TIMINE WAY, PENDLETON, OR 978019417 (Tel: 5419669830)

📍
Updated Business Mailing Address April 24, 2018

Registered at 46314 TIMINE WAY, PENDLETON, OR 978019417 (Tel: 5419669830)

NPI Profile Active February 07, 2018

NPI status registered as active in NPPES database

📍
Updated Practice Location February 07, 2018

Registered at 73265 CONFEDERATED WAY, PENDLETON, OR 978019099 (Tel: 5419669830)

📍
Updated Business Mailing Address February 07, 2018

Registered at 73265 CONFEDERATED WAY, PENDLETON, OR 978019099 (Tel: 5419669830)

👤
Provider Name / Credentials Updated February 07, 2018

Recorded as GLAVIS WAGNER

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 07, 2018

Counselor (License #17-CRM-217 in OR)

🟢
Initial NPI Registration & Enumeration February 07, 2018

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1720587553
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 07, 2018
Last Update: July 23, 2020
Sole Proprietor: No

Mailing Address

46314 Timine Way

Pendleton, OR 978019417

Phone: 5419669830

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.