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

The Wallace Medical Concern

Organization Dentist · NPI 1841592110

The Wallace Medical Concern is a Dentist in Portland, Oregon. Registered with an NPI since 2010.

In the registry since
2010
Specialties on file
8
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Practice location Address checks out

18633 SE Stark St Ste 401
Portland, OR 97233-5468
Phone: (503) 489-1760
Fax: (503) 489-1763
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Federally Qualified Health Center (FQHC) (primary) Taxonomy 261QF0400X
Dentist Taxonomy 122300000X
Dental Hygienist Taxonomy 124Q00000X
Family Medicine Physician Taxonomy 207Q00000X
Dental Clinic/Center Taxonomy 261QD0000X
Non-Pharmacy Dispensing Site Taxonomy 332900000X
Family Nurse Practitioner Taxonomy 363LF0000X
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X

Record details

NPI number1841592110
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lisa Cline — Chief Executive Officer · (503) 489-1760
Other names Wallace; Wallace Medical Concern
NPI enumeratedNovember 18, 2010
Last updated in NPPESMay 22, 2026
Certification dateMay 22, 2026
Mailing address18633 Se Stark St Ste 401, Portland, OR 97233-5468

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