EARNEST WALLACE III PSS
NPI 1730927815
Peer Specialist in Portland, OR

Q: What is Earnest Wallace's NPI number?

The NPI number for Earnest Wallace is 1730927815. It was assigned to this individual provider in the NPPES registry on July 15, 2024.

Q: What is Earnest Wallace's specialty?

The primary specialty registered for this NPI is Peer Specialist with taxonomy code 175T00000X.

Q: When was this NPI record last updated?

The NPPES record for Earnest Wallace was last updated on July 15, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.

Active since July 15, 2024

5201 SW WESTGATE DR STE 100, PORTLAND, OR 97221(469) 297-0096 Get Directions Write a Review

NPPES record last updated: July 15, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Earnest Wallace Iii Pss NPPES

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

EARNEST WALLACE III PSS (NPI 1730927815) is an individual peer specialist in Portland, Oregon, licensed in Oregon (111712) and active in the NPI registry since July 2024.

NPPES Registry Identity

NPI1730927815

Entity TypeIndividualMale

Primary Taxonomy175T00000X

Provider Legal NameEARNEST WALLACE IIICredential: PSS

Location Address5201 SW WESTGATE DR STE 100Portland, OR 97221-2424

Mailing Address423 Mckinley StCedar Hill, TX 75104-2287

Phone(469) 297-0096

Sole ProprietorYes

Enumeration DateJuly 15, 2024

NPPES CertifiedJuly 15, 2024

✔ NPI 1730927815 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPeer SpecialistOther Service Providers

Taxonomy Code175T00000X

License✔ Licensed in OR · 111712

Definition

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.

5201 SW WESTGATE DR STE 100, Portland, OR 97221

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Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LIGHTHOUSE COUNSELING CENTER LLC

Clinic/Center (Adult Mental Health)

5201 SW WESTGATE DR STE 100
PORTLAND, OR 97221

Multnomah County (469) 297-0096

COREHEALTH BEHAVIORAL HEALTH

Clinic/Center (Mental Health (Including Community Mental Health Center))

5201 SW WESTGATE DR STE 100
PORTLAND, OR 97221

Multnomah County (786) 779-1203

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 Earnest Wallace's NPI number?

The NPI number for Earnest Wallace is 1730927815. It was assigned to this individual provider in the NPPES registry on July 15, 2024.

Where is Earnest Wallace located?

Earnest Wallace practices at 5201 SW Westgate Dr Ste 100, Portland, OR 97221. The listed phone number is (469) 297-0096.

What is Earnest Wallace's specialty?

The primary specialty registered for this NPI is Peer Specialist with taxonomy code 175T00000X.

When was this NPI record last updated?

The NPPES record for Earnest Wallace was last updated on July 15, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.