MICHAEL WALLER
NPI 1760360531
Social Worker - Clinical in Portland, OR

Active since August 21, 2025
4110 NE 122ND AVE STE 110, PORTLAND, OR 97230(503) 832-0792 Get Directions Write a Review

NPPES record last updated: May 18, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Michael Waller NPPES

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

MICHAEL WALLER (NPI 1760360531) is an individual clinical provider in Portland, Oregon, licensed in Oregon (L17560) and active in the NPI registry since August 2025.

NPPES Registry Identity

NPI1760360531
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameMICHAEL WALLER
Location Address4110 NE 122ND AVE STE 110Portland, OR 97230-1359
Mailing Address501 N Dixon StPortland, OR 97227-1804
Sole ProprietorNo
Enumeration DateAugust 21, 2025
Last NPPES UpdateMay 18, 2026
NPPES CertifiedMay 18, 2026
NPI 1760360531 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License Licensed in OR · L17560
Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

4110 NE 122ND AVE STE 110, Portland, OR 97230

Other Providers at the Same Location NPPES

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

Social Worker (Clinical)
4110 NE 122ND AVE STE 110
PORTLAND, OR 97230

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 Michael Waller's NPI number?

The NPI number for Michael Waller is 1760360531. It was assigned to this individual provider in the NPPES registry on August 21, 2025.

Where is Michael Waller located?

Michael Waller practices at 4110 NE 122nd Ave Ste 110, Portland, OR 97230. The listed phone number is (503) 832-0792.

What is Michael Waller's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

When was this NPI record last updated?

The NPPES record for Michael Waller was last updated on May 18, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.