WYMAN MACON NPI 1053060772

NPI Information

NPI: 1053060772
Provider Name: WYMAN MACON
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
605 SE CESAR E CHAVEZ BLVD
PORTLAND, OR
ZIP 97214
Phone: (503) 231-7480
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Wyman Macon is an addiction (substance use disorder) counselor in Portland, OR. Wyman Macon NPI is 1053060772. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

605 SE CESAR E CHAVEZ BLVD
PORTLAND, OR
ZIP 97214-216
Phone: (503) 231-7480

The enumeration date for this NPI number is 3/21/2022 and was last updated on 4/7/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	171M00000X	Case Manager/Care Coordinator				No
2	101YA0400X	Counselor	Addiction (Substance Use Disorder)			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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