Dr. Jeffery Wise
Nurse Practitioner - Psychiatric/Mental Health
1834 Nw 25th Ave Apt 504
Portland
, Oregon 97210-2764
Dr. Jeffery Wise
Nurse Practitioner - Psychiatric/Mental Health
1834 Nw 25th Ave Apt 504
Portland
, Oregon 97210-2764
(971) 354-9242
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About
Features
Specialties
- Nurse Practitioner - Psychiatric/Mental Health
Languages spoken
- English
Location
First Address
- Dr. Jeffery Wise
- 1834 Nw 25th Ave Apt 504
- Portland, OR
- Zip : 97210-2764
- Phone : (971) 354-9242
Second Address
- Dr. Jeffery Wise
- 1834 Nw 25th Ave Apt 504
- Portland, OR
- Zip : 97210-2764
- Phone : (971) 354-9242
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 01606596NP-PP | OR |
National Provider Identifier
| NPI | 1003361858 |
|---|---|
| Provider Name | Dr. Jeffery Wise |
| First Address | Portland, OR 97210-2764 |
| Second Address | Portland, OR 97210-2764 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 22/08/2016 |
| Last Update Date | 13/01/2022 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.