Individual
MR. GEORGE NATHAN WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
9040 JACKSON AVE, TACOMA, WA 98431-0001
(360) 440-0655
Mailing address
2305 10TH ST, BREMERTON, WA 98312-3850
(360) 440-0655
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10004592
WA
Other
Enumeration date
11/04/2005
Last updated
11/21/2019
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