NPI 1881429918

The Wallace Medical Concern

Organisation Family Medicine Physician Gresham, OR

Practice location

Address: 1165 N Main Ave, Gresham, OR 97030-5543
Phone: (503) 489-1760
Fax: (503) 489-1763
Mailing address: 18633 SE Stark St STE 401, Portland, OR 97233-5468

Authorised official

Name: Lisa Cline
Title: Ceo
Phone: (503) 489-1760

Registered specialties (3)

Family Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207Q00000X

Other Family Medicine providers in Oregon →

Social Worker

Behavioral Health & Social Service Providers Taxonomy 104100000X

Other Social Worker providers in Oregon →

Dental Hygienist

Dental Providers Taxonomy 124Q00000X

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Registry record

NPI: 1881429918
Entity type: Organization
NPI issued: 6 Sep 2024
Record last updated: 6 Sep 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.