Provider Demographics
NPI:1164965554
Name:BIGGS, CHARLES RALPH JR
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:RALPH
Last Name:BIGGS
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:622 46TH ST
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:OR
Mailing Address - Zip Code:97103-2202
Mailing Address - Country:US
Mailing Address - Phone:253-514-3023
Mailing Address - Fax:
Practice Address - Street 1:422 GATEWAY AVE STE 210
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:OR
Practice Address - Zip Code:97103
Practice Address - Country:US
Practice Address - Phone:503-325-4584
Practice Address - Fax:503-741-3089
Is Sole Proprietor?:No
Enumeration Date:2016-12-02
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor