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

Agustina Wallace

Individual provider Peer Specialist · NPI 1811856339

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 Ave
Portland, OR 97205-1703
Phone: (503) 535-3860
Show map & directions

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 number1811856339
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJanuary 20, 2026
Last updated in NPPESJanuary 20, 2026
Certification dateJanuary 20, 2026
Mailing address1132 Sw 13th Ave, Portland, OR 97205-1703

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