Michael Waller

NPI 1760360531 · on the registry since 2025

Practice

Address: 4110 Ne 122nd Ave Ste 110
Portland, OR 97230
Phone: (503) 832-0792
Organisation at this address: Cemented Rose Therapeutics, Llc
Waller Wholistic Wellness & Consulting
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 11

Registry record

Primary taxonomy: 1041C0700X
1041C0700X
Licence states on file: OR
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2026-05-18

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oregon