SAMUEL RUSSELL WAGGONER
NPI 1316658974
Counselor - Addiction (Substance Use Disorder) in Portland, OR

Q: What is Samuel Waggoner's NPI number?

The NPI number for Samuel Waggoner is 1316658974. It was assigned to this individual provider in the NPPES registry on December 5, 2022.

Q: What is Samuel Waggoner's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

Q: When was this NPI record last updated?

The NPPES record for Samuel Waggoner was last updated on December 5, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since December 05, 2022

2727 NE FLANDERS ST, PORTLAND, OR 97232(503) 238-5203 Get Directions Write a Review

NPPES record last updated: December 5, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Samuel Russell Waggoner NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAMUEL RUSSELL WAGGONER (NPI 1316658974) is an individual addiction (substance use disorder) provider in Portland, Oregon, licensed in Oregon (T-22-1492) and active in the NPI registry since December 2022.

NPPES Registry Identity

NPI1316658974

Entity TypeIndividualMale

Primary Taxonomy101YA0400X

Provider Legal NameSAMUEL RUSSELL WAGGONER

Location Address2727 NE FLANDERS STPortland, OR 97232-3159

Mailing Address2901 E Burnside StPortland, OR 97214-1831 · (503) 238-5203

Phone(503) 238-5203

Sole ProprietorNo

Enumeration DateDecember 5, 2022

NPPES CertifiedDecember 5, 2022

✔ NPI 1316658974 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers

Taxonomy Code101YA0400X

License✔ Licensed in OR · T-22-1492

2727 NE FLANDERS ST, Portland, OR 97232

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Samuel Waggoner's NPI number?

The NPI number for Samuel Waggoner is 1316658974. It was assigned to this individual provider in the NPPES registry on December 5, 2022.

Where is Samuel Waggoner located?

Samuel Waggoner practices at 2727 NE Flanders St, Portland, OR 97232. The listed phone number is (503) 238-5203.

What is Samuel Waggoner's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Samuel Waggoner was last updated on December 5, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.