Individual provider · Type 1 NPI

Suzanne Renee Wallace

Addiction (Substance Use Disorder) Counselor · Portland, OR

NPI number 1518864800 Active

Practice location

6828 SE Holgate Blvd
Portland, OR 97206-3504

Call (503) 795-3987 Map

Fax (503) 908-3998

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XT-26-6998 (OR)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1518864800

Suzanne Renee Wallace's National Provider Identifier is 1518864800, issued on Oct 21, 2026. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Portland, OR. The record was last updated on Oct 21, 2026.