Individual provider · Type 1 NPI

Ethan Wallace

Mental Health Counselor · Hillsboro, OR

NPI number 1225531791 Active

Practice location

222 SE 8th Ave Ste 212
Hillsboro, OR 97123-4218

Call (503) 352-7333 Map

Other practice locations

  • 1411 SW Morrison St Ste 310, Portland, OR 97205-1945 · (503) 352-2400

Specialties and licenses

TaxonomyCodeLicense
Counselor 101Y00000XNone listed
Mental Health Counselor Primary 101YM0800XNone listed

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About NPI 1225531791

Ethan Wallace's National Provider Identifier is 1225531791, issued on Mar 12, 2018. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Hillsboro, OR. The record was last updated on Jul 23, 2021.