Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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MS. Suzanne Kapuamailani Wallace, MSW, ASW, LCSW

Individual provider Clinical Social Worker · NPI 1467587618

MS. Suzanne Kapuamailani Wallace, MSW, ASW, LCSW is a Clinical Social Worker in Portland, Oregon. Qualified in 2000, 26 years ago. Practices with Providence Health and Services Oregon, a 1,426-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Oregon.

Years since qualifying
26
Licensed in
OR
In the registry since
2007
What do these letters mean?
MSW — Master of Social Work
The graduate degree in social work.
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

9911 SE Mount Scott Blvd
Portland, OR 97266-6302
Phone: (503) 258-4200
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence L3489 (OR)

Record details

NPI number1467587618
Entity typeIndividual (Type 1)
GenderFemale
Credentials MSW , ASW , LCSW
Sole proprietorYes
NPI enumeratedFebruary 21, 2007
Last updated in NPPESNovember 1, 2013

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2000 (26 years in practice)
Group practice Providence Health And Services Oregon — 1426 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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