WALLACE
NPI 1215390091
Clinic/Center - Primary Care in Portland, OR
- Organization
- Clinic/Center
- Primary Care
- Accepts Insurance
- CLIA Number: 38D0690059
- CLIA Cert. Type: Federally Qualified Health Center
- CLIA Exp. Date: 01-17-2027
About WALLACE
This page provides the complete NPI Profile along with additional information for Wallace, a primary care provider established in Portland, Oregon operating as a Clinic/center, focusing in primary care . The healthcare provider is registered in the NPI registry with number 1215390091 assigned on March 2016. The practitioner's primary taxonomy code is 261QP2300X. The provider is registered as an organization and their NPI record was last updated 4 years ago. Wallace operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's is doing business as Wallace. The authorized official of this NPI record is Stuart Currie Md, Mmm (Cmo)
- NPI
- 1215390091 Verify this NPI
- Provider Legal Name
- THE WALLACE MEDICAL CONCERN
- Other Organization Name
- WALLACE
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 18139 NE COUCH STREET PORTLAND, OR 97230
- Location Phone
- (503) 489-1760
- Mailing Address
- 18139 NE COUCH STREET PORTLAND, OR 97230
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 03-30-2016
- Last Update Date
- 02-24-2022
- Code Navigator
A primary care provider (PCP) like Wallace sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Primary Care
- Taxonomy Code
- 261QP2300X
- Type
- Ambulatory Health Care Facilities
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 122300000X | Dental Providers | Dentist | |
| 2 | 124Q00000X | Dental Providers | Dental Hygienist |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- BridgeSpan Standard Bronze Plan - EPO
- BridgeSpan Standard Gold Plan - EPO
- BridgeSpan Standard Silver Plan - EPO
- Bronze 8000 Individual Connect - EPO
- Bronze Essential 9000 With 4 Copay No Deductible Office Visits Individual Connect - EPO
- Bronze HSA 7000 Individual Connect - EPO
- Gold 2300 Individual Connect - EPO
- Regence Standard Bronze Plan Individual Connect - EPO
- Regence Standard Gold Plan Individual Connect - EPO
- Regence Standard Silver Plan Individual Connect - EPO
- Silver 6500 Individual Connect - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 38D0690059
- Facility Type
- Federally Qualified Health Center
- Certificate Effective Date
- January 18, 2025
- Certificate Expiration Date
- January 17, 2027
- Laboratory Director
- DR. STUART J. CURRIE
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Wallace to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1215390091, enumerated as an "organization" on March 30, 2016.
The provider is located at 18139 NE COUCH STREET PORTLAND, OR 97230 and the phone number is (503) 489-1760.
Clinic/Center with taxonomy code 261QP2300X and a focus in Primary Care.
The provider might be accepting Accepts: BridgeSpan Health Company and Regence BlueCross. Please consult your insurance carrier or call the provider to verify.
