| Waller Wholistic Wellness & Consulting | |
|
4110 Ne 122nd Ave Ste 110 Portland OR 97230-1359 | |
| (503) 832-0792 | |
| Not Available |
| Full Name | Waller Wholistic Wellness & Consulting |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 4110 Ne 122nd Ave Ste 110, Portland, Oregon |
| Authorized Official Name and Position | Michael Waller (SOCIAL WORKER) |
| Authorized Official Contact | 5035447058 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Waller Wholistic Wellness & Consulting 15667 Se Rainier Ave Clackamas OR 97015-9423 Ph: (503) 544-7058 | Waller Wholistic Wellness & Consulting 4110 Ne 122nd Ave Ste 110 Portland OR 97230-1359 Ph: (503) 832-0792 |
| NPI Number | 1861338303 |
|---|---|
| Provider Enumeration Date | 04/27/2026 |
| Last Update Date | 04/27/2026 |
| Certification Date | 04/27/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861338303 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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