Charles L Wanke, CRM

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

16-CRM-054 Issued in OR

Practice address

4585 SW 185TH Ave
Aloha, OR 97078-1557

Phone

(503) 591-9280

NPI assigned

Jul 27, 2017

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

Other identifiers 1

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": "1501113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1609390020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4585 SW 185TH AVE",
            "city": "ALOHA",
            "state": "OR",
            "postal_code": "970781557",
            "telephone_number": "503-591-9280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4585 SW 185TH AVE",
            "city": "ALOHA",
            "state": "OR",
            "postal_code": "970781557",
            "telephone_number": "503-591-9280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANKE",
        "first_name": "CHARLES",
        "middle_name": "L",
        "credential": "CRM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-27",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "16-CRM-054",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500729602",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Waleed Almulla DMD
• Walgreen Co
• John Wallace
• Arin Ann Wallington, MA MFT
• Melodi Ann Walsh
• Ondra Rae Watson, CPM, LDM
• Maureen Connor Weatherspoon, EFDA
• Christy Weinfurtner
• Thomas Patrick Welch, MD
• Scott Alan Weller, DVM

• Addiction (Substance Use Disorder) Counselor in Aloha, OR
• Providers in Aloha, OR by specialty
• Addiction (Substance Use Disorder) Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2024; 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.