IndividualActive
Anthony Wilson, CRM
NPI 1396201216 · Peer Specialist · Coos Bay, OR
Provider details
- NPI number
- 1396201216
- Entity type
- Individual
- Primary specialty
- Peer SpecialistOther Service Providers
- Credential
- CRM
- Sex
- Male
- Sole proprietor
- No
- License
- 19-CRM-044 (OR)
Specialties & taxonomies
Other Service Providers
Profile Score
Detailed profile(76/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
3 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
155 S Empire Blvd
Coos Bay, OR 97420-3374
Phone: (541) 256-4686
Street-level locationGet directions
Mailing address
1942 Sheridan Ave
North Bend, OR 97459-3416
Additional practice locations (2)
- 1435 Ne 4th St Ste BBend, OR 97701-4268Phone: (541) 306-4446Fax: (541) 550-2011
- 125 Sw C StMadras, OR 97741-1458Phone: (541) 306-4566Fax: (541) 320-9005
Registry dates
- Enumerated
- 2019-02-15
- Last updated
- 2020-01-31
- Certified
- 2020-01-31
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.