Individual
DR. JEFFERY WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
1220 SW MORRISON ST STE 730, PORTLAND, OR 97205-2226
(971) 354-9242
Mailing address
1750 NE VISTA AVE, GRESHAM, OR 97030-4160
(503) 781-5814
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
01606596NP-PP
OR
Other
Enumeration date
08/22/2016
Last updated
02/05/2025
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