Individual provider · Type 1 NPI

Mike Wallace

Peer Specialist · Dallas, OR

NPI number 1881413680 Active

Practice location

945 SE Uglow Ave
Dallas, OR 97338-2642

Call (503) 837-1762 Map

Mailing address

1170 Barnes Ave SE Apt 222
Salem, OR 97306-3560

Specialties and licenses

TaxonomyCodeLicense
Peer Specialist Primary 175T00000X2627 (OR)

Peer Specialist: Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

3 other providers at this address

Other peer specialist providers in Dallas

See all in Dallas →

About NPI 1881413680

Mike Wallace's National Provider Identifier is 1881413680, issued on Oct 8, 2024. The primary taxonomy on file is Peer Specialist (175T00000X), and the practice location is in Dallas, OR. The record was last updated on Oct 8, 2024.