Individual provider · Type 1 NPI

Charles Annich, PSS/CRM

Peer Specialist · Portland, OR

NPI number 1194608901 Active

Practice location

1310 SW 17th Ave
Portland, OR 97201-2522

Fax (503) 467-4077

Mailing address

211 SE Caruthers St
Portland, OR 97214-4502

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor 101YA0400X24-CRM-3669 (OR)
Peer Specialist Primary 175T00000X113891 (OR)

Peer Specialist: Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

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About NPI 1194608901

Charles Annich, PSS/CRM's National Provider Identifier is 1194608901, issued on Jul 29, 2025. The primary taxonomy on file is Peer Specialist (175T00000X), and the practice location is in Portland, OR. The record was last updated on Jul 29, 2025.