Michelle Antoinette Wickliff, T/CHW,DOULA,CRM,HCW

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

License

111929 Issued in OR

Practice address

1218 NE Mariners Loop
Portland, OR 97211-1577

Phone

(503) 933-7271

NPI assigned

Sep 12, 2025

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1757635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773878400000",
    "number": "1306717459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1218 NE MARINERS LOOP",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972111577",
            "telephone_number": "503-933-7271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1218 NE MARINERS LOOP",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972111577",
            "telephone_number": "503-933-7271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKLIFF",
        "first_name": "MICHELLE",
        "middle_name": "ANTOINETTE",
        "credential": "T/CHW,DOULA,CRM,HCW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-12",
        "last_updated": "2026-03-19",
        "certification_date": "2026-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374J00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Doula",
            "state": "OR",
            "license": "111929",
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Community Health Worker",
            "state": "OR",
            "license": "111929",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "OR",
            "license": "111929",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Wick, LMT 27215
• Judy L Wick, RN
• Kyra Jo Wick, M.S., CFY-SLP
• Shelby Wick
• Carey Wickham
• Laura Marie Wickline, PMHNP
• Natalie Rose Wickline, DDS
• Roger A Wicklund, M.D.
• Jacob Wicks
• Melody Ann Wickstrom

• Community Health Worker in Portland, OR
• Providers in Portland, OR by specialty
• Community Health Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.