KIMBERLY WALLACE (NPI# 1942592340) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942592340 |
| Entity Type | Individual |
| Full Name | KIMBERLY WALLACE |
| Credential | CADC 1 |
| Practice Address |
1427 Se 182nd Ave Portland OR 97233-5008 |
| Practice Telephone | 9712027851 |
| Practice Fax Number | 5032067164 |
| Enumeration Date | 2011-05-04 |
| Last Update Date | 2018-10-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
140414 | OR | Behavioral Health & Social Service Providers |
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033457791 | Kimberly Wallace | Physical Therapist | 421 W School House Ln Unit 2, Philadelphia, PA 19144-4557 | 2013-01-30 |
| 1669794137 | Kimberly Wallace | Registered Nurse | 214 Rosewood Ter, Cheektowaga, NY 14225-3016 | 2010-02-24 |
| 1770627705 | Kimberly Shannon Wallace | Family Medicine | 1438 Defense Hwy Suite 201, Gambrills, MD 21054 | 2007-02-15 |
| 1144881640 | Kimberly Veronica Wallace | Advanced Practice Midwife | 100 Lillian Gish Blvd Sw Ste 201, Massillon, OH 44647-6500 | 2019-06-25 |
| 1316413271 | Kimberly Pauline Wallace | Pharmacist | 951 Central St, Franklin, NH 03235-2028 | 2018-10-18 |
| 1942705223 | Kimberly Wallace | Technician | 1312 S 8th St, Las Vegas, NV 89104-1638 | 2018-03-28 |
| 1043713936 | Kimberly Louise Wallace | Registered Nurse | 2040 Babcock Rd Ste 304, San Antonio, TX 78229-4428 | 2018-03-16 |
| 1265969133 | Kimberly Wallace | Registered Nurse | 3400 Bainbridge Ave, Bronx, NY 10467-2404 | 2017-05-22 |
| 1083091987 | Kimberly Wallace | Counselor | 1944 Brannan Rd, Mcdonough, GA 30253-4310 | 2015-04-29 |
| 1750785622 | Kimberly Wallace | Licensed Practical Nurse | 138 North Court Street, Wampsville, NY 13163 | 2014-10-21 |
| Street Address |
1427 SE 182ND AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97233-5008 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366082828 | Takayla Lee | Counselor | 1427 Se 182nd Ave, Portland, OR 97233-5008 | 2020-01-13 |
| 1700432127 | Dave William Crosby | Counselor | 1427 Se 182nd Ave, Portland, OR 97233-5008 | 2019-08-12 |
| 1568014850 | Shelli Stuhr | Counselor | 1427 Se 182nd Ave, Portland, OR 97233-5008 | 2019-07-16 |
| 1457903494 | Douglas Wayne Oglesby I | Counselor | 1427 Se 182nd Ave, Portland, OR 97233-5008 | 2019-07-10 |
| 1679036297 | Hillary Jo Milovich | Counselor | 1427 Se 182nd Ave, Portland, OR 97233-5008 | 2019-04-10 |
| 1255898946 | Angela Giovanna Brambila | Counselor | 1427 Se 182nd Ave, Portland, OR 97233-5008 | 2019-02-28 |
| 1265997779 | Kathryn Dorthea Fuqua | Counselor | 1427 Se 182nd Ave, Portland, OR 97233-5008 | 2019-02-08 |
| 1538623491 | Katie Jo Mcmurry | Counselor | 1427 Se 182nd Ave, Portland, OR 97233-5008 | 2019-01-24 |
| 1972083186 | Amanda Burkholder | Counselor | 1427 Se 182nd Ave, Portland, OR 97233-5008 | 2018-08-16 |
| 1235618943 | Kassy Lynn Stone | Counselor | 1427 Se 182nd Ave, Portland, OR 97233-5008 | 2018-08-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205448164 | Moore Therapy Services, LLC | Behavioral Analyst | 2053 Se 181st Ave, Portland, OR 97233 | 2020-08-20 |
| 1427563733 | Central City Concern Inc | Clinic/Center | 1415 Se 122nd Ave, Portland, OR 97233 | 2017-12-08 |
| 1427573443 | Sunshine Ahc | In Home Supportive Care | 2217 Se 156th Ave, Portland, OR 97233 | 2017-08-10 |
| 1538609433 | Nathaniel Davis Jr. | Counselor | 8915 Se Center St, Tigard, OR 97233 | 2017-02-27 |
| 1154878627 | Oregon Outreach Inc | Case Management | 1740 South East 139th Avenue, Portland, OR 97233 | 2016-09-01 |
| 1023461019 | Julianne Baltzley | Counselor | 2409 Se 149th Avenue, Portland, OR 97233 | 2016-07-14 |
| 1710332143 | Emma Slater | Counselor | 12360 Se Burnside, Portland, OR 97233 | 2016-05-04 |
| 1245621952 | Gregory Brett Bledsoe | Counselor | 1427 Se 182nd Ave., Portland, OR 97233 | 2015-02-17 |
| 1396149852 | Jacqueline Bension | Counselor | 1705 Se 122nd Ave, Portland, OR 97233 | 2014-10-13 |
| 1700206950 | Olga I Zlatova I | Dental Hygienist | 325 Se 154th Ave, Portland, OR 97233 | 2014-04-25 |
| Find all providers in zip 97233 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477163657 | Kevin Charles Reiser | Counselor | 2318 Ne Martin Luther King Blvd, Portland, OR 97212-3715 | 2020-08-03 |
| 1881203628 | Beau Curtiss | Counselor | 7916 Se Foster Rd Ste 203, Portland, OR 97206-4289 | 2020-07-28 |
| 1851916886 | Jonathan Cross | Counselor | 49 Montrose Ave Apt 3, Portland, ME 04103-2442 | 2020-06-16 |
| 1639703960 | Elizabeth Ann Anderson | Counselor | 1820 Sw Vermont St Ste J, Portland, OR 97219-1945 | 2020-02-25 |
| 1194356618 | Deforrest Kwesi Jackson | Counselor | 122 Ne 122nd Ave Ste 200, Portland, OR 97230-2103 | 2020-02-03 |
| 1760012942 | Jesse Decker | Counselor | 7015 N Boston Ave, Portland, OR 97217-5711 | 2020-01-16 |
| 1740829076 | Ryan Christianson | Counselor | 2707 Ne Flanders St, Portland, OR 97232-3159 | 2020-01-03 |
| 1083264477 | Kayla Rose Paris | Counselor | 420 Cumberland Ave, Portland, ME 04101-2823 | 2019-09-17 |
| 1275193260 | Anna Khval | Counselor | 1500 Se 122nd Ave, Portland, OR 97233-1207 | 2019-06-20 |
| 1841855301 | Portland Opioid Health Home | Counselor | 48 Free St., Mezzanine Level, Portland, ME 04101 | 2019-05-09 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.