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

Candace Nicole Wallis

Individual provider Clinical Social Worker · NPI 1215691597

Candace Nicole Wallis is a Clinical Social Worker in Coos Bay, Oregon. Qualified in 2020, 6 years ago. Practices with Coastal Center, LLC, a 5-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
6
Licensed in
FL
In the registry since
2021

Practice location Address checks out

125 Central Ave Ste 290
Coos Bay, OR 97420-2342
Phone: (541) 267-2113
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 15085 (FL)

Record details

NPI number1215691597
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedOctober 24, 2021
Last updated in NPPESOctober 24, 2021
Certification dateOctober 24, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Coastal Center, Llc. — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Coos Bay