MRS. TESSA WATERBURY WALLACE LCSW
NPI 1578705950
Social Worker - Clinical in White Salmon, WA
About Mrs. Tessa Waterbury Wallace Lcsw NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. TESSA WATERBURY WALLACE LCSW (NPI 1578705950) is an individual clinical provider in White Salmon, Washington, licensed in Washington (LW60171285) and active in the NPI registry since March 2009. She is enrolled in Medicare PECOS, maintains a secondary practice location in The Dalles, and is a graduate of Other (2003).
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Other Identifiers 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Mrs. Tessa Waterbury Wallace Lcsw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Tessa Waterbury Wallace reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
White Salmon, WA 98672
- Reassigned Medicare billing, Washington enrollment
- 14 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 98672 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 4
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Tessa Waterbury Wallace's NPI number?
The NPI number for Tessa Waterbury Wallace is 1578705950. It was assigned to this individual provider in the NPPES registry on March 31, 2009.
Where is Tessa Waterbury Wallace located?
Tessa Waterbury Wallace practices at 65371 Hwy 14, White Salmon, WA 98672. The listed phone number is (509) 493-2133.
What is Tessa Waterbury Wallace's specialty?
The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.
Is Tessa Waterbury Wallace enrolled in Medicare?
Yes. Tessa Waterbury Wallace is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Tessa Waterbury Wallace's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Tessa Waterbury Wallace reassigns Medicare benefits to One Community Health (White Salmon, WA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Tessa Waterbury Wallace's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Tessa Waterbury Wallace accept?
Health plans from Moda Health Plan, Inc., PacificSource Health Plans, Premera Blue Cross Blue Shield of Alaska and Providence Health Plan list Tessa Waterbury Wallace 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 Tessa Waterbury Wallace was last updated on January 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months 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.
# Mrs. Tessa Waterbury Wallace, LCSW · NPI 1578705950
Clinical provider in White Salmon, Washington. Individual provider, active in the CMS NPPES registry since March 31, 2009.
## Identity
- **NPI:** 1578705950 (Entity type: Individual)
- **Enumerated:** March 31, 2009
- **Primary specialty:** Social Worker - Clinical · taxonomy 1041C0700X
- **State license:** LW60171285 (Washington)
- **Sole proprietor:** No
## Practice location
- **Address:** 65371 HWY 14, White Salmon, WA 98672-9867
- **Phone:** (509) 493-2133
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** One Community Health (NPI 1376221259, White Salmon, WA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2003
## Record status
- **NPPES last updated:** January 13, 2025
- **Other identifiers:** Medicaid 2014480 (WA); Medicaid 218112 (OR)
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Source: [NPI Profile](https://npiprofile.com/npi/1578705950) · Data from the CMS NPPES public registry.