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

Mary Wallace

Individual provider Mental Health Counselor · NPI 1255760898

Mary Wallace is a Mental Health Counselor in Vancouver, Washington. Qualified in 2015, 11 years ago. Practices with Peacehealth, a 99-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Washington.

Years since qualifying
11
Licensed in
WA
In the registry since
2013
Specialties on file
3
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Practice location Address checks out

400 NE Mother Joseph Pl
Vancouver, WA 98664-3200
Phone: (360) 514-2216
Fax: (360) 514-6527
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1818 Se Division St, Portland, OR 97202-1159 — (503) 963-7619

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence LH61086337 (WA)
Mental Health Counselor Taxonomy 101YM0800X
Adult Companion Taxonomy 372600000X

Record details

NPI number1255760898
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedNovember 4, 2013
Last updated in NPPESDecember 22, 2021
Certification dateDecember 22, 2021

Medicare enrollment

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

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Peacehealth — 99 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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