Charles Annich, PSS/CRM

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

113891 Issued in OR

Practice address

1310 SW 17TH Ave
Portland, OR 97201-2522

Phone

(503) 231-2641

Fax

(503) 467-4077

NPI assigned

Jul 29, 2025

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1753747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753747200000",
    "number": "1194608901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 SE CARUTHERS ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972144502",
            "telephone_number": "503-224-1044",
            "fax_number": "971-260-0355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 SW 17TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972012522",
            "telephone_number": "503-231-2641",
            "fax_number": "503-467-4077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANNICH",
        "first_name": "CHARLES",
        "credential": "PSS/CRM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-07-29",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "24-CRM-3669",
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OR",
            "license": "113891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Annand Counseling Centr
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• Anne Emmett Therapy LLC
• Anne Fleming, MD, LLC
• Annette Stevko
• Annie Grummel, LLC
• Annie Munson-Phelps, LLC
• Annlabray Psy.D., PC
• Brenda R Annotti, F.N.P.
• Brittania Haunani Anoai-Gonzalez

• Peer Specialist in Portland, OR
• Providers in Portland, OR by specialty
• Peer Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.