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Dr. Carol Ann Wallace , MD

Physician • Clackamas, OR

Active NPI 1639272412 Individual Practitioner Female Practitioner
Practice location in NPPES

10180 Se Sunnyside Rd
Clackamas, OR 970158970

Call 5036522880 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

10180 Se Sunnyside Rd

Clackamas, OR 970158970

Telephone 5036522880
Organization at the Same NPPES Address or Phone
Kaiser Foundation Health Plan Northwest Facility NPI 1528002474

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2006

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, “Does your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo · Report an error.

Specialties & License Numbers Reported to NPPES

Health Maintenance Organization Primary Specialty

NUCC Taxonomy Code: 302R00000X

License # reported to NPPES OR MD14314

(1) A form of health insurance in which its members prepay a premium for the HMO's health services which generally include inpatient and ambulatory care. For the patient, an HMO means reduced out-of-pocket costs (i.e. no deductible), no paperwork (i.e. insurance forms), and only a small copayment for each office visit to cover the paperwork handled by the HMO; (2) A organization of health care personnel and facilities that provides a comprehensive range of health services to an enrolled population for a fixed sum of money paid in advance for a specified period of time. These health services include a wide variety of medical treatments and consults, inpatient and outpatient hospitalization, home health service, ambulance service, and sometimes dental and pharmacy services. The HMO may be organized as a group model, an individual practice association (IPA), a network model or a staff model.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Oregon Medical Board.
Look Up on State Board Site

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

22 listed
Dr. Marcus Asby , MD

Internal Medicine

NPI 1104112697

Doctor of Medicine (M.D.)

Dr. Patra Behary , MD

Internal Medicine

NPI 1083716773

Doctor of Medicine (M.D.)

Dr. Carla Bowman , MD

Family Medicine

NPI 1093874901

Doctor of Medicine (M.D.)

Dr. Lisa Burton , MD

Family Medicine

NPI 1043315690

Doctor of Medicine (M.D.)

NPI 1093978025

Doctor of Medicine (M.D.)

Dr. Clay Elrod , DO

Radiology - Vascular & Interventional Radiology

NPI 1104132497

Doctor of Osteopathic Medicine (D.O.)

Career & Practice History

NPI enumerated September 06, 2006.

No changes to the name, practice address, taxonomy or NPI status in this record have been observed in the monthly NPPES data files from January 2017 to August 2026.

No reviews have been published yet. Leave a review.

NPI Administrative Meta

NPI Number: 1639272412
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 06, 2006
Last Update: July 08, 2007
Sole Proprietor: Yes

Mailing Address

2220 Ne 32nd Ave

Portland, OR 972125108

Phone: 5032826611

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.