Mandi Danielle Wallace, is a
Student In An Organized Health Care Education/training Program based in Portland, Oregon. Mandi Danielle Wallace is licensed to practice in * (Not Available) (license number ) and her current practice location is
32 Ne 11th Ave, Portland, Oregon. She can be reached at her office (for appointments etc.) via phone at
(503) 542-7635.
NPI number for Mandi Danielle Wallace is 1992367916 and her current mailing address is 32 Ne 11th Ave, Portland, Oregon. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1992367916.
Healthcare Provider's Profile
| Full Name | Mandi Danielle Wallace |
|---|
| Gender | Female |
|---|
| Speciality | Student In An Organized Health Care Education/training Program |
|---|
| Location | 32 Ne 11th Ave, Portland, Oregon |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1992367916
- Provider Enumeration Date: 06/29/2019
- Last Update Date: 01/08/2024
Medical Identifiers
Medical identifiers for Mandi Danielle Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1992367916 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mandi Danielle Wallace is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mandi Danielle Wallace,
32 Ne 11th Ave,
Portland, OR 97232-3001
Ph: (503) 542-7635 | Mandi Danielle Wallace,
32 Ne 11th Ave,
Portland, OR 97232-3001
Ph: (503) 542-7635 |
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