Individual provider · Type 1 NPI

Jason David Wallis, LPC

Professional Counselor · Portland, OR

NPI number 1396913331 Active

Practice location

2901 E Burnside St
Portland, OR 97214-1831

Call (503) 953-0310 Map

Mailing address

3500 NE Martin Luther King Jr Blvd Ste 200
Portland, OR 97212-2093

Other practice locations

  • 3500 NE Martin Luther King Jr Blvd Ste 200, Portland, OR 97212-2093 · (503) 496-3201

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500XC7443 (OR)

Professional Counselor: Definition to come...

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About NPI 1396913331

Jason David Wallis, LPC's National Provider Identifier is 1396913331, issued on Feb 12, 2008. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Portland, OR. The record was last updated on Apr 17, 2025.