Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1881413680 Individual Practitioner Male Practitioner

Mike Wallace

Peer Specialist • Dallas, OR

Professional Overview & Biography Verified Profile Summary

Mike Wallace is a registered healthcare professional specializing in Peer Specialist in Dallas, OR. Practice services are available at 945 SE UGLOW AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

945 Se Uglow Ave

Dallas, OR 973382642

Telephone 5038371762

Specialty Benchmarks & Practice Insights

Comparative analytics for Peer Specialist in Dallas, OR

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
22 Specialists

Practicing in Dallas, OR (3408 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2024-10-08
Peer Specialist Primary Specialty

NUCC Taxonomy Code: 175T00000X

State License OR 2627

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners
NPI 1457115990
Shelby White , PSS

Peer Specialist

NPI 1548078074
Stephanie Gibson , PSS

Peer Specialist

NPI 1861171308

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active October 08, 2024

NPI status registered as active in NPPES database

📍
Updated Practice Location October 08, 2024

Registered at 945 SE UGLOW AVE, DALLAS, OR 973382642 (Tel: 5038371762)

📍
Updated Business Mailing Address October 08, 2024

Registered at 1170 BARNES AVE SE APT 222, SALEM, OR 973063560 (Tel: 5039491008)

👤
Provider Name / Credentials Updated October 08, 2024

Recorded as MIKE WALLACE

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 08, 2024

Peer Specialist (License #2627 in OR)

🟢
Initial NPI Registration & Enumeration October 08, 2024

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1881413680
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 08, 2024
Last Update: October 08, 2024
Sole Proprietor: Yes

Mailing Address

1170 Barnes Ave Se Apt 222

Salem, OR 973063560

Phone: 5039491008

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.