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

Waller Wholistic Wellness & Consulting

Organization Clinical Social Worker · NPI 1861338303

Waller Wholistic Wellness & Consulting is a Clinical Social Worker in Portland, Oregon. Registered with an NPI since 2026.

In the registry since
2026

Practice location Address checks out

4110 NE 122nd Ave Ste 110
Portland, OR 97230-1359
Phone: (503) 832-0792
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X

Record details

NPI number1861338303
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michael Waller — Social Worker · (503) 544-7058
NPI enumeratedApril 27, 2026
Last updated in NPPESApril 27, 2026
Certification dateApril 27, 2026
Mailing address15667 Se Rainier Ave, Clackamas, OR 97015-9423

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