Individual provider · Type 1 NPI

Mary Wallace

Mental Health Counselor · Vancouver, WA

NPI number 1255760898 Active

Practice location

400 NE Mother Joseph Pl
Vancouver, WA 98664-3200

Call (360) 514-2216 Map

Fax (360) 514-6527

Mailing address

PO Box 8459
Portland, OR 97207-8459

Other practice locations

  • 1818 SE Division St, Portland, OR 97202-1159 · (503) 963-7619

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor 101YM0800XNone listed
Adult Companion 372600000XNone listed
Mental Health Counselor Primary 101YM0800XLH61086337 (WA)

Mental Health Counselor: Definition to come...

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About NPI 1255760898

Mary Wallace's National Provider Identifier is 1255760898, issued on Nov 4, 2013. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Vancouver, WA. The record was last updated on Dec 22, 2021.