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Organization
WALLER WHOLISTIC WELLNESS & CONSULTING
Active
Organization
WALLER WHOLISTIC WELLNESS & CONSULTING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL WALLER LCSW (SOCIAL WORKER)
(503) 544-7058
Entity
Organization
Contact information
Practice address
4110 NE 122ND AVE STE 110, PORTLAND, OR 97230-1359
(503) 832-0792
Mailing address
15667 SE RAINIER AVE, CLACKAMAS, OR 97015-9423
(503) 544-7058
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
04/27/2026
Last updated
04/27/2026
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