Wanke, Charles L

Wanke, Charles L is an individual health care provider with primary practice located at 4585 Sw 185Th Ave , Aloha OR 97078-1557. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Case Manager/Care Coordinator, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is his primary health care specialty. Wanke, Charles L can be contacted via phone (503) 591-9280.

Contact Information

Primary practice address
4585 Sw 185Th Ave Aloha OR 97078-1557
Phone: (503) 591-9280
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Case Manager/Care Coordinator 171M00000X
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 16-CRM-054 Oregon

Profile Details

NPI number 1609390020
LBN Legal business name Wanke, Charles L
Credentials CRM
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 27th, 2017
Last updated Nov 21st, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609390020 NPPES
Oregon MEDICAID 500729602

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