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

Individual provider Music Therapist · NPI 1497469597

Mikelia Wallace, MT-BC is a Music Therapist in Portland, Oregon. Practices as a sole proprietor. Registered with an NPI since 2023.

In the registry since
2023
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Practice location Address checks out

12608 SE Alder St Apt 60
Portland, OR 97233-1688
Phone: (352) 303-5352
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Music Therapist (primary) Taxonomy 225A00000X · Licence 16398

Record details

NPI number1497469597
Entity typeIndividual (Type 1)
GenderFemale
Credentials MT-BC
Sole proprietorYes
NPI enumeratedJanuary 12, 2023
Last updated in NPPESJanuary 12, 2023
Certification dateJanuary 12, 2023

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