The Wallace Medical Concern
Federally Qualified Health Center (FQHC)
18633 Se Stark St Ste 401, Portland
Oregon, 97233-5468
503-489-1760 503-489-1763
The Wallace Medical Concern is a Federally Qualified Health Center (FQHC) in Portland, Oregon. It is located at 18633 Se Stark St Ste 401, Portland and it's customer support contact number is 503-489-1760. The authorized person of The Wallace Medical Concern is Ms. Lisa A. Cline who is Chief Executive Officer of the pharmacy and her contact number is 503-489-1760. The Wallace Medical Concern accepts medicare which means medicare covered patients will not be billed for any more than the Medicare deductible and coinsurance.
The Wallace Medical Concern is definition to come...
Pharmacy Details:
The Wallace Medical Concern type, location, contact phone number and fax are as below. Patients can directly walkin to the pharmacy or can call on the below given customer support phone number for enquiries.
| Name: | The Wallace Medical Concern |
| Type: | Federally Qualified Health Center (FQHC) |
| Location: | 18633 Se Stark St Ste 401, Portland,
Oregon, 97233-5468 |
| Phone: | 503-489-1760 |
| Fax: | 503-489-1763 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this pharmacy is as below. Person's position and contact details are also mentioned below.
| Name: | Ms. Lisa A. Cline |
| Position: | Chief Executive Officer |
| Contact Number: | 503-489-1760 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given pharmacy are as mentioned below.
| NPI Number: | 1841592110 |
| NPI Enumeration Date: | 18 Nov, 2010 |
| NPI Last Update On: | 22 May, 2026 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for The Wallace Medical Concern are as mentioned below.
| Specialization | License Number | State | Status | |
| Federally Qualified Health Center (FQHC) | | | Primary | |
| Dentist | | | Secondary | |
| Dental Hygienist | | | Secondary | |
| Family Medicine | | | Secondary | |
| Dental | | | Secondary | |
| Non-pharmacy Dispensing Site | | | Secondary | |
| Family | | | Secondary | |
| Psych/Mental Health | | | Secondary | |
Medicare Enrollment:
The Wallace Medical Concern is enrolled in medicare and it's Pac Id, enrollment Id, registered name and type is as stated below.
| PAC ID: |
Enrollment ID: |
Org Name | Medicare Entity Type |
| 2365680865 | O20130522000417 | The Wallace Medical Concern | PART A PROVIDER - FEDERALLY QUALIFIED HEALTH CENTER (FQHC) |
| 2365680865 | O20150224001107 | The Wallace Medical Concern | PART B SUPPLIER - CLINIC/GROUP PRACTICE |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 18633 Se Stark St Ste 401,
Portland, Oregon |
| Zip: | 97233-5468 |
| Phone Number: | 503-489-1760 |
| Fax Number: | 503-489-1763 |
Patients can reach The Wallace Medical Concern at
18633 Se Stark St Ste 401, Portland, Oregon or can
call on customer care at 503-489-1760.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 13 July, 2026.