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

Mrs. Tessa Waterbury Wallace, LCSW

Individual provider Clinical Social Worker · NPI 1578705950

Mrs. Tessa Waterbury Wallace, LCSW is a Clinical Social Worker in White Salmon, Washington. Qualified in 2003, 23 years ago. Practices with One Community Health, a 53-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Oregon and Washington.

Years since qualifying
23
Licensed in
OR, WA
In the registry since
2009
Specialties on file
2
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

65371 Hwy 14
White Salmon, WA 98672-9867
Phone: (509) 493-2133
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1620 E 12th St, The Dalles, OR 97058 — (541) 296-9151

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence LW60171285 (WA)
Clinical Social Worker Taxonomy 1041C0700X · Licence L4499 (OR)

Record details

NPI number1578705950
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorNo
NPI enumeratedMarch 31, 2009
Last updated in NPPESJanuary 13, 2025
Certification dateJanuary 13, 2025

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2003 (23 years in practice)
Group practice One Community Health — 53 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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