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MANDI DANIELLE WALLACE
NPI 1992367916
Student in an Organized Health Care Education/Training Program in Portland, OR

Active since June 29, 2019
32 NE 11TH AVE, PORTLAND, OR 97232(503) 542-7635 Get Directions Write a Review

NPPES record last updated: January 8, 2024. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Mandi Danielle Wallace NPPES

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

MANDI DANIELLE WALLACE (NPI 1992367916) is an individual student in an organized health care education/training program in Portland, Oregon and active in the NPI registry since June 2019. She maintains a secondary practice location in Tigard.

NPPES Registry Identity

NPI1992367916
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameMANDI DANIELLE WALLACE
Location Address32 NE 11TH AVEPortland, OR 97232-3001
Mailing Address32 Ne 11th AvePortland, OR 97232-3001 · (503) 542-7635
Phone(503) 542-7635
Sole ProprietorNo
Enumeration DateJune 29, 2019
Last NPPES UpdateJanuary 8, 2024
NPPES CertifiedJanuary 8, 2024
✔ NPI 1992367916 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X
32 NE 11TH AVE, Portland, OR 97232
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Secondary Practice Location 1

Location 18915 SW Center StTigard, OR 97223-6307

Other Providers at the Same Location NPPES 20

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

NW ANXIETY INSTITUTE, LLC
Counselor (Mental Health)
32 NE 11TH AVE
PORTLAND, OR 97232
Multnomah County (503) 542-7635
JULIE ANNA KELLY
Counselor (Professional)
32 NE 11TH AVE
PORTLAND, OR 97232
Multnomah County (503) 542-7635
MR. SAMUEL GOLDBERG
Student in an Organized Health Care Education/Training Program
32 NE 11TH AVE
PORTLAND, OR 97232
Multnomah County (503) 542-7635
AMY OLSON
Counselor (Mental Health)
32 NE 11TH AVE
PORTLAND, OR 97232
Multnomah County (503) 542-7635
AMY M SHORE BS
Student in an Organized Health Care Education/Training Program
32 NE 11TH AVE
PORTLAND, OR 97232
Multnomah County (503) 542-7635
DAVIS BARRETT FOGG
Student in an Organized Health Care Education/Training Program
32 NE 11TH AVE
PORTLAND, OR 97232
Multnomah County (503) 542-7635
MAGGIE ROSE DAVIDSON
Student in an Organized Health Care Education/Training Program
32 NE 11TH AVE
PORTLAND, OR 97232
Multnomah County (503) 542-7635
ALEXANDER NAPOLES
Student in an Organized Health Care Education/Training Program
32 NE 11TH AVE
PORTLAND, OR 97232
Multnomah County (503) 542-7635

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 Mandi Wallace's NPI number?

The NPI number for Mandi Wallace is 1992367916. It was assigned to this individual provider in the NPPES registry on June 29, 2019.

Where is Mandi Wallace located?

Mandi Wallace practices at 32 NE 11th Ave, Portland, OR 97232. The listed phone number is (503) 542-7635.

What is Mandi Wallace's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Mandi Wallace was last updated on January 8, 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.