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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

THE WALLACE MEDICAL CONCERN
NPI 1215390091
Dentist in Portland, OR

Active since March 30, 2016CLIA 38D0690059 · Waiver
18139 NE COUCH STREET, PORTLAND, OR 97230(503) 489-1760 Get Directions Write a Review

NPPES record last updated: September 17, 2026. Verified against the NPPES registry weekly; last sync: September 27, 2026.

Record update history: Sep 17, 2026, Feb 24, 2022, Jun 25, 2021 and 1 more (4 updates tracked since 2016).

About The Wallace Medical Concern NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THE WALLACE MEDICAL CONCERN (NPI 1215390091), doing business as Wallace, is a healthcare organization registered as a dentist in Portland, Oregon and active in the NPI registry since March 2016. The organization holds a CLIA Waiver certificate valid through January 17, 2027 and lists Michelle Sirianni, Director Of Compliance, as its authorized official.

NPPES Registry Identity

NPI1215390091
Entity TypeOrganization
Primary Taxonomy122300000X
Legal Business NameTHE WALLACE MEDICAL CONCERN
Location Address18139 NE COUCH STREETPortland, OR 97230
Mailing Address18139 Ne Couch StPortland, OR 97230-7222
Phone(503) 489-1760
Organization SubpartNo
Authorized OfficialMichelle SirianniDirector Of Compliance · (503) 489-1760
Enumeration DateMarch 30, 2016
Last NPPES UpdateSeptember 17, 20264 updates tracked since enumeration
NPPES CertifiedSeptember 17, 2026
✔ NPI 1215390091 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
Also ListedDental HygienistTaxonomy 124Q00000X
Also ListedClinic/Center · Primary CareTaxonomy 261QP2300X
18139 NE COUCH STREET, Portland, OR 97230
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Other Names 1

Doing Business AsWallace

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Regence BlueCross BlueShield of Oregon.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 38D0690059

Wallace Medical Concern · Portland, OR
Active · expires Jan 17, 2027
CLIA Number38D0690059
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateJanuary 18, 2025
Certificate Expiration DateJanuary 17, 2027
Laboratory DirectorDr. Stuart J. Currie
Laboratory Phone(503) 489-1760
Laboratory LocationWallace Medical Concern18633 SE Stark Street, Ste 401, Portland, OR 97233
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is The Wallace Medical Concern's NPI number?

The NPI number for The Wallace Medical Concern is 1215390091. It was assigned to this organization in the NPPES registry on March 30, 2016. The provider is doing business as Wallace.

Where is The Wallace Medical Concern located?

The Wallace Medical Concern is located at 18139 NE Couch Street, Portland, OR 97230. The listed phone number is (503) 489-1760.

What is The Wallace Medical Concern's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Does The Wallace Medical Concern hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 38D0690059) is associated with this NPI, valid through January 17, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does The Wallace Medical Concern accept?

Health plans from BridgeSpan Health Company and Regence BlueCross BlueShield of Oregon list The Wallace Medical Concern as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for The Wallace Medical Concern was last updated on September 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.