Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

The Wallace Medical Concern

Organization Family Nurse Practitioner · NPI 1215390109

The Wallace Medical Concern is a Family Nurse Practitioner in Gresham, Oregon. Registered with an NPI since 2016.

In the registry since
2016

Practice location Address checks out

254 NW Burnside Rd
Gresham, OR 97030
Phone: (503) 489-1760
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X

Record details

NPI number1215390109
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official William Roller — Operations Director · (503) 489-1760
NPI enumeratedMarch 30, 2016
Last updated in NPPESMarch 30, 2016
Mailing address254 Nw Burnside Road, Gresham, OR 97030

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