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

Madison Wallace

Individual provider Behavior Technician · NPI 1417503657

Madison Wallace is a Behavior Technician in Portland, Oregon. Registered with an NPI since 2019.

In the registry since
2019

Practice location Address checks out

1025 SE 11th Ave Apt 302
Portland, OR 97214-2482
Phone: (503) 686-1786
Show map & directions

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

Specialties & licences

Behavior Technician (primary) Taxonomy 106S00000X

Record details

NPI number1417503657
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 13, 2019
Last updated in NPPESAugust 13, 2019
Mailing address1025 Se 11th Ave Apt 302, Portland, OR 97214-2482

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