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

Michael Waller

Individual provider Clinical Social Worker · NPI 1760360531

Michael Waller is a Clinical Social Worker in Portland, Oregon. Licensed in Oregon. Registered with an NPI since 2025.

Licensed in
OR
In the registry since
2025

Practice location Address checks out

4110 NE 122nd Ave Ste 110
Portland, OR 97230-1359
Phone: (503) 832-0792
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 L17560 (OR)

Record details

NPI number1760360531
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 21, 2025
Last updated in NPPESMay 18, 2026
Certification dateMay 18, 2026

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