GLAVIS M WAGNER
NPI 1720587553
Prevention Professional in Pendleton, OR

Q: What is Glavis Wagner's NPI number?

The NPI number for Glavis Wagner is 1720587553. It was assigned to this individual provider in the NPPES registry on February 7, 2018.

Q: What is Glavis Wagner's specialty?

The primary specialty registered for this NPI is Prevention Professional with taxonomy code 405300000X.

Q: When was this NPI record last updated?

The NPPES record for Glavis Wagner was last updated on July 23, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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 February 07, 2018

46314 TIMINE WAY, PENDLETON, OR 97801(541) 966-9830 Get Directions Write a Review

NPPES record last updated: July 23, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 23, 2020, Jul 10, 2018, Apr 24, 2018 (3 updates tracked since 2018).

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About Glavis M Wagner NPPES

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

GLAVIS M WAGNER (NPI 1720587553) is an individual prevention professional provider in Pendleton, Oregon, licensed in Oregon (17-CRM-217) and active in the NPI registry since February 2018.

NPPES Registry Identity

NPI1720587553

Entity TypeIndividualMale

Primary Taxonomy405300000X

Provider Legal NameGLAVIS M WAGNER

Location Address46314 TIMINE WAYPendleton, OR 97801

Mailing Address46314 Timine WayPendleton, OR 97801-9417 · (541) 966-9830 · Fax (541) 278-7568

Phone(541) 966-9830

Sole ProprietorNo

Enumeration DateFebruary 7, 2018

Last NPPES UpdateJuly 23, 20203 updates tracked since enumeration

NPPES CertifiedJuly 23, 2020

✔ NPI 1720587553 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPrevention ProfessionalOther Service Providers

Taxonomy Code405300000X

License✔ Licensed in OR · 17-CRM-217

Definition

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.

Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 17-CRM-217 (OR)

Also ListedPeer SpecialistTaxonomy 175T00000X · License THW000002415 (OR)

46314 TIMINE WAY, Pendleton, OR 97801

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CODY M CIMMIYOTTI

Peer Specialist