The Wallace Medical Concern

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

THE WALLACE MEDICAL CONCERN

Practice address

18633 SE Stark St Ste 401
Portland, OR 97233-5468

Phone

(503) 489-1760

NPI assigned

Oct 1, 2021

Organization subpart

No

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

Authorized official

Name

Michelle Sirianni

Title

Ea & Federal Grants Program Manager

Phone

(503) 489-1760

Specialties & licenses 1

Addresses

Tax ID family

The Wallace Medical Concern4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• The Wallace Medical Concern

  • Primary Care Clinic/Center
  • Portland, OR
  • NPI 1215390091
  NPD tax ID
• The Wallace Medical Concern

  • Family Nurse Practitioner
  • Gresham, OR
  • NPI 1215390109
  NPD tax ID
• The Wallace Medical Concern

  • Family Medicine Physician
  • Gresham, OR
  • NPI 1881429918
  NPD tax ID

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

{
    "created_epoch": "1633046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774224000000",
    "number": "1558033118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18633 SE STARK ST STE 401",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972335468",
            "telephone_number": "503-489-1760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18633 SE STARK ST STE 401",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972335468",
            "telephone_number": "503-489-1760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE WALLACE MEDICAL CONCERN",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-01",
        "last_updated": "2026-03-23",
        "certification_date": "2026-03-23",
        "status": "A",
        "authorized_official_last_name": "SIRIANNI",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "EA & FEDERAL GRANTS PROGRAM MANAGER",
        "authorized_official_telephone_number": "503-489-1760"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Vasectomy Clinic, P.C.
• The Vital Compass
• The Vu Centre for Plastic and Hand Surgery
• The Waldorf Center for Plastic Surgery
• The Wallace Medical Concern
• The Wallace Medical Concern
• The Wellness Center PDX
• The Wig Gallery LLC
• Sandra Thein
• Andria D Theiss, BS

• Dental Clinic/Center in Portland, OR
• Providers in Portland, OR by specialty
• Dental Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 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.