Wallace

LBN: The Wallace Medical Concern
Wallace is an health care organization with primary practice located at 18633 Se Stark St Ste 401 , Portland OR 97233-5468. The organization recently has 8 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / Dental Hygienist, Allopathic & Osteopathic Physicians / Family Medicine, Ambulatory Health Care Facilities / Community Health, Ambulatory Health Care Facilities / Dental, Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC), Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) is the primary health care specialty. The Wallace Medical Concern can be contacted via phone (503) 489-1760, or through Cline, Lisa A. via phone (503) 489-1760.

Contact Information

Primary practice address
18633 Se Stark St Ste 401 Portland OR 97233-5468
Phone: (503) 489-1760
Fax: (503) 489-1763
Website:
Map and Directions
Authorized official contact:
Name: Cline, Lisa A.
Phone: (503) 489-1760

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X
Dental Providers / Dental Hygienist 124Q00000X
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X
Ambulatory Health Care Facilities / Community Health 261QC1500X
Ambulatory Health Care Facilities / Dental 261QD0000X
Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) 261QF0400X
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X

Profile Details

NPI number 1841592110
LBN Legal business name The Wallace Medical Concern
DBA Doing business as Wallace
Authorized official Cline, Lisa A.
Entity Organization
Organization subpart 1 No
Enumeration date Nov 18th, 2010
Last updated Feb 24th, 2022 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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