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

Kimberly Wallace, CADC1

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1942592340

Kimberly Wallace, CADC1 is an Addiction (Substance Use Disorder) Counselor in Portland, Oregon. Licensed in Oregon. Registered with an NPI since 2011.

Licensed in
OR
In the registry since
2011
Specialties on file
2

Practice location Address checks out

1427 SE 182nd Ave
Portland, OR 97233-5008
Phone: (971) 202-7851
Fax: (503) 206-7164
Show map & directions

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

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence 140414 (OR)

Record details

NPI number1942592340
Entity typeIndividual (Type 1)
GenderFemale
Credentials CADC1
Sole proprietorNo
NPI enumeratedMay 4, 2011
Last updated in NPPESOctober 4, 2018

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