Active NPI
David Wenzel, PH.D.
- Professional Counselor
- Sandy, OR
National Provider Identifier
1801060496
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 1012
- Practice address
- 39085 Pioneer Blvd Ste 104
Sandy, OR 97055-8062 - Phone
- (503) 668-5001
- Fax
- (503) 388-3162
- NPI assigned
- Apr 15, 2008
- Last updated
- Apr 24, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 1012 | OR | Primary |
Addresses
Primary practice location
39085 Pioneer Blvd Ste 104
Sandy, OR 97055-8062
Mailing address
46575 SE Jadrny Rd
Sandy, OR 97055-7463
Phone (503) 803-0444
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1012 | OR | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208217600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1524528000000",
"number": "1801060496",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "46575 SE JADRNY RD",
"city": "SANDY",
"state": "OR",
"postal_code": "970557463",
"telephone_number": "503-803-0444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "39085 PIONEER BLVD STE 104",
"city": "SANDY",
"state": "OR",
"postal_code": "970558062",
"telephone_number": "503-668-5001",
"fax_number": "503-388-3162"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WENZEL",
"first_name": "DAVID",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-04-15",
"last_updated": "2018-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OR",
"license": "1012",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sandy, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.