The Wallace Medical Concern
NPI 1881429918ActiveOrganization· Family Medicine· Gresham, OR
Family Medicine in Gresham, Oregon, registered in NPPES in September 2024. The authorized official on file is Lisa Cline, MPH, Ceo. Enrolled in Medicare as part a provider - federally qualified health center (fqhc).
Overview
| NPI | 1881429918 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 6, 2024 |
| Last updated in NPPES | Sep 6, 2024 |
| Certified by provider | Sep 6, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | — | — |
| Social Worker | 104100000X | — | — |
| Dental Hygienist | 124Q00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part A Provider - Federally Qualified Health Center (FQHC) (OR) |
|---|
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