Waller Wholistic Wellness & Consulting

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

WALLER WHOLISTIC WELLNESS & CONSULTING

Practice address

4110 NE 122ND Ave Ste 110
Portland, OR 97230-1359

Phone

(503) 832-0792

NPI assigned

Apr 27, 2026

Organization subpart

No

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

Authorized official

Name

Michael Waller, LCSWNPI 1760360531

Title

Social Worker

Phone

(503) 544-7058

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael Waller

  • Clinical Social Worker
  • Portland, OR
  • NPI 1760360531
  NPD Authorized official

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

{
    "created_epoch": "1777248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777248000000",
    "number": "1861338303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15667 SE RAINIER AVE",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970159423",
            "telephone_number": "503-544-7058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 NE 122ND AVE STE 110",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972301359",
            "telephone_number": "503-832-0792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALLER WHOLISTIC WELLNESS & CONSULTING",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-27",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "status": "A",
        "authorized_official_last_name": "WALLER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "SOCIAL WORKER",
        "authorized_official_telephone_number": "503-544-7058",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Summer Nicole Wallaert
• Martine Rose Wallenberg, MS, ED.D, LMHC, LPC
• Ryan Wallenberg, M.D.
• Daniel Wallenslager, PHARMD
• Olivia R Waller Setniker
• Chris Waller
• Kathryn Grace Waller, M.S., CFY-SLP
• Michael Waller
• Nancy Jane Waller, CRNFA
• Delaney Wallerich

• Clinical Social Worker in Portland, OR
• Providers in Portland, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 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.