Megan E Wallin, QMHA-I

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

19-QMHA-I-01995 Issued in OR

Practice address

12360 E Burnside St
Portland, OR 97233-1042

Phone

(971) 279-4800

Fax

(971) 279-2051

NPI assigned

Feb 19, 2014

Last updated

Apr 2, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Cascadia Behavioral Healthcare

  • Nursing Facility/Intermediate Care Facility
  • Portland, OR
  • NPI 1922265685
  NPD (past)
• Cascadia Behavioral Healthcare Inc

  • Multi-Specialty Clinic/Center
  • Portland, OR
  • NPI 1568549855
  NPD (past)

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

{
    "created_epoch": "1392768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585785600000",
    "number": "1932524592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1776 SW MADISON ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972051715",
            "telephone_number": "503-224-1044",
            "fax_number": "503-621-2235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12360 E BURNSIDE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972331042",
            "telephone_number": "971-279-4800",
            "fax_number": "971-279-2051"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2375 NW Glisan St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972103420",
            "country_code": "US",
            "telephone_number": "503-243-2236",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLIN",
        "first_name": "MEGAN",
        "middle_name": "E",
        "credential": "QMHA-I",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-19",
        "last_updated": "2020-04-02",
        "certification_date": "2020-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "19-QMHA-I-01995",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500762418",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathryn Grace Waller, M.S., CFY-SLP
• Michael Waller
• Nancy Jane Waller, CRNFA
• Delaney Wallerich
• Tracie Walliker, LMT
• Grace Bailey Wallingford, RD
• Anne Wallis, RN
• Jason David Wallis, LPC
• Jennifer Wallis, LCSW, CADCIII
• Jordann Wallis, MS, CGC

• Mental Health Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2020; 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.