Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
THE WALLACE MEDICAL CONCERN
Active
Organization
THE WALLACE MEDICAL CONCERN
Active
Other names
Wallace
Organization subpart
No
Provider details
NPI number
Authorized official
LISA CLINE MPH (CEO)
(503) 489-1760
Entity
Organization
Contact information
Practice address
1165 N MAIN AVE, GRESHAM, OR 97030-5543
(503) 489-1760
(503) 489-1763
Mailing address
18633 SE STARK ST STE 401, PORTLAND, OR 97233-5468
(503) 489-1760
(503) 489-1763
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
NULL
104100000X
Social Worker
—
—
124Q00000X
Dental Hygienist
—
NULL
124Q00000X
Dental Hygienist
—
—
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
09/06/2024
Last updated
09/06/2024
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign upProduct
Developers