THE WALLACE MEDICAL CONCERN NPI 1881429918

NPI Information

  • NPI: 1881429918
  • Provider Name: THE WALLACE MEDICAL CONCERN
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Address: 1165 N MAIN AVE
    GRESHAM, OR
    ZIP 97030
  • Phone: (503) 489-1760

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NPI Details

THE WALLACE MEDICAL CONCERN is a family medicine in Gresham, OR. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. THE WALLACE MEDICAL CONCERN NPI is 1881429918. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1165 N MAIN AVE
GRESHAM, OR
ZIP 97030-543
Phone: (503) 489-1760
Fax: (503) 489-1763

The provider's authorized official is Lisa Cline .
The authorized official title is Ceo and has the following contact phone number (503) 489-1760.

The enumeration date for this NPI number is 9/6/2024 and was last updated on 9/6/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1104100000XSocial WorkerNo
2124Q00000XDental HygienistNo
3207Q00000XFamily MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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