Individual provider Active NPI

Erin Michelle Wallace, M.D.

  • Psychiatry Physician
  • Woodburn, OR
National Provider Identifier
1730405598
Registry record updated Apr 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD164348 Issued in OR
Practice address
1475 Mount Hood Ave Ste 160
Woodburn, OR 97071-9263
Phone
(971) 983-5214
NPI assigned
Apr 19, 2010
Last updated
Apr 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD164348 OR Primary

Addresses

Primary practice location

1475 Mount Hood Ave Ste 160
Woodburn, OR 97071-9263

Mailing address

PO Box 3417
Portland, OR 97208-3417
Phone (503) 413-3900

Other practice location 1

9800 SE Sunnyside Rd
Clackamas, OR 97015-9750
Phone (503) 249-3434

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE) Northwest Permanente PC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140910002169 OR Practitioner - Psychiatry 4981849684 Reassigns benefits to 2 organizations
I20191007003092 WA Practitioner - Psychiatry 4981849684 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Oregon Health Sciences University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Silverton HealthGroup PAC ID 8921901877, 147 clinicians

Practice addresses (Care Compare)

1475 Mount Hood Ave
Suite 160
Woodburn, OR 97071-9263
Phone (971) 983-5214

Merit-based Incentive Payment System (MIPS)

Final score
95.41 of 100Reported as group
Quality
88.83
Promoting interoperability
100
Improvement activities
40
Cost
82.4

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD164348ORMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Jul 28, 2014 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Jul 15, 2019 Accepting new patients
Legacy Salmon Creek Hospital CurrentSince Mar 3, 2025 Accepting new patients
Silverton Health Current Accepting new patients
Legacy Salmon Creek Hospital CurrentSince Mar 3, 2025 Accepting new patients
Silverton Health CurrentSince Apr 16, 2024 Accepting new patients
Silverton Health CurrentSince Apr 16, 2024 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Jul 28, 2014 Accepting new patients

Locations

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

10163 SE Sunnyside Rd
Ste 490
Clackamas, OR 97015
Phone (503) 513-4400

9800 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2457

9800 SE Sunnyside Rd
Ste 490
Clackamas, OR 97015

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

342 Fairview St
Silverton, OR 97381
Phone (503) 525-7660

347 Fairview St
Silverton, OR 97381
Phone (503) 873-5667

1475 Mount Hood Ave
Ste 160
Woodburn, OR 97071
Phone (971) 983-5214

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1271635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713225600000",
    "number": "1730405598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3417",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083417",
            "telephone_number": "503-413-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 MOUNT HOOD AVE STE 160",
            "city": "WOODBURN",
            "state": "OR",
            "postal_code": "970719263",
            "telephone_number": "971-983-5214"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9800 SE Sunnyside Rd",
            "address_purpose": "LOCATION",
            "city": "Clackamas",
            "state": "OR",
            "postal_code": "970159750",
            "country_code": "US",
            "telephone_number": "503-249-3434",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "ERIN",
        "middle_name": "MICHELLE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-19",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OR",
            "license": "MD164348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Northwest Permanente PC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9800 SE Sunnyside Rd",
            "city": "Clackamas",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970159750",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Woodburn, OR

Sources for this page

Verify at the official NPI Registry.