Agustina Wallace
Agustina Wallace is a Peer Specialist in Portland, Oregon. Licensed in Oregon. Registered with an NPI since 2026.
- Licensed in
- OR
- In the registry since
- 2026
Practice location Address checks out
1132 SW 13th AvePortland, OR 97205-1703
Phone: (503) 535-3860
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Peer Specialist (primary) | Taxonomy 175T00000X · Licence 109318 (OR) |
|---|
Record details
| NPI number | 1811856339 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | No |
| NPI enumerated | January 20, 2026 |
| Last updated in NPPES | January 20, 2026 |
| Certification date | January 20, 2026 |
| Mailing address | 1132 Sw 13th Ave, Portland, OR 97205-1703 |
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