AGUSTINA WALLACE
Peer Specialist
Active
Individual
NPI: 1811856339
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Peer Specialist | 175T00000X | Yes | 109318 (OR) |
Frequently Asked Questions
NPI 1811856339 is the National Provider Identifier for AGUSTINA WALLACE, a Peer Specialist provider located in Portland, OR. This NPI was enumerated on January 20, 2026.
AGUSTINA WALLACE practices at 1132 SW 13TH AVE, Portland, OR 97205.
Quick Facts
- NPI
- 1811856339
- Type
- Individual
- Enumerated
- Jan 20, 2026
- Last Updated
- Jan 20, 2026
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