IndividualActive
Mikelia Wallace, MT-BC
NPI 1497469597 · Music Therapist · Portland, OR
Provider details
- NPI number
- 1497469597
- Entity type
- Individual
- Primary specialty
- Music TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- MT-BC
- Sex
- Female
- Sole proprietor
- Yes
- License
- 16398
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
12608 Se Alder St Apt 60
Portland, OR 97233-1688
Phone: (352) 303-5352
Approximate (ZIP-level) locationGet directions
Mailing address
12608 Se Alder St Apt 60
Portland, OR 97233-1688
Registry dates
- Enumerated
- 2023-01-12
- Last updated
- 2023-01-12
- Certified
- 2023-01-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.