Individual provider · Type 1 NPI

Cory Alexis Wallace

Mental Health Counselor · Tigard, OR

NPI number 1447740238 Active

Practice location

8915 SW Center St
Tigard, OR 97223-6307

Call (503) 726-3690 Map

Other practice locations

  • 5801 NE Cornelius Pass Rd, Hillsboro, OR 97124-9370 · (971) 762-1144

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

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About NPI 1447740238

Cory Alexis Wallace's National Provider Identifier is 1447740238, issued on May 16, 2018. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Tigard, OR. The record was last updated on Mar 30, 2021.