JEFFERY WISE (NPI# 1003361858) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003361858 |
| Entity Type | Individual |
| Full Name | JEFFERY WISE |
| Credential | PMHNP-BC |
| Practice Address |
5415 Se Milwaukie Ave Portland OR 97202-4940 |
| Practice Telephone | 5032335405 |
| Mailing Telephone | 5032335405 |
| Enumeration Date | 2016-08-22 |
| Last Update Date | 2016-08-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
01606596NP-PP | OR | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
5415 SE MILWAUKIE AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97202-4940 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700853173 | Nancy Kahaner | Obstetrics & Gynecology | 5415 Se Milwaukie Ave, Suite 1, Portland, OR 97202-4940 | 2006-03-03 |
| 1417492851 | Michal Sierra Dedrick | Behavioral Analyst | 5415 Se Milwaukie Ave, Portland, OR 97202-4940 | 2016-12-20 |
| 1780138248 | Raeshawn Chresfield | Counselor | 5415 Se Milwaukie Ave, Portland, OR 97202-4940 | 2016-08-12 |
| 1437523461 | Chanel Walker-harris | Counselor | 5415 Se Milwaukie Ave, Portland, OR 97202 | 2015-11-13 |
| 1477920858 | Yvonne Carpenter | Behavioral Analyst | 5415 Se Milwaukie Ave, Portland, OR 97202-4940 | 2015-09-01 |
| 1518348515 | Tristan Penn | Behavioral Analyst | 5415 Se Milwaukie Ave, Portland, OR 97202-4940 | 2015-06-16 |
| 1093122806 | Stephanie Mijo | Behavioral Analyst | 5415 Se Milwaukie Ave, Portland, OR 97202-4940 | 2014-07-14 |
| 1891075685 | Robin D Steger | Counselor | 5415 Se Milwaukie Ave, Portland, OR 97202-4940 | 2011-08-24 |
| 1134433790 | Nancy Kahaner Do PC | Clinic/Center | 5415 Se Milwaukie Ave, Ste 1, Portland, OR 97202-4940 | 2010-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073143442 | Carewell LLC | Counselor | Portland River Park Center, 205 Se Spokane St Suite 358, Portland, OR 97202 | 2020-01-24 |
| 1588226765 | Melissa Lynn Hartley | Counselor | 1235 Se Division St. Suite 103, Portland, OR 97202 | 2019-07-08 |
| 1275192999 | Kimberly Rae Kilgore | Counselor | 5509 Se 22nd St #3a, Portland, OR 97202 | 2019-06-06 |
| 1639736069 | Kyra Steinhauer | Social Worker | 3145 Se Powell Blvd, Portland, OR 97202 | 2019-05-21 |
| 1134644321 | Bridgette Hennigsen | Social Worker | 3810 Se 11th Ave, Portland, OR 97202 | 2017-08-08 |
| 1558895789 | Lenore Cangeloso | Acupuncturist | 1235 Se Division Street, Suie 117, Portland, OR 97202 | 2017-04-14 |
| 1376099093 | Anna Christine Leclerc | Contractor | 2024 Se Clinton Street, Zenana Spa and Wellness Center, Portland, OR 97202 | 2016-09-01 |
| 1144684663 | Catholic Charities | Case Management | 2740 Se Powell Blvd., Portland, OR 97202 | 2016-04-11 |
| 1881082097 | Zoomcare Dental, P.C. | Dentist | 3130 Se Division Street, Building 2, Portland, OR 97202 | 2014-12-23 |
| 1124424700 | Jessica Nash | Counselor | 6411 Se 17th Ave, Portland, OR 97202 | 2014-11-10 |
| Find all providers in zip 97202 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154920148 | Hardcore Happy LLC | Nurse Practitioner | 740 Ne 116th Ct, Portland, OR 97220-2223 | 2020-10-20 |
| 1457967325 | Megan L Langworthy | Nurse Practitioner | 1914 Se 46th Ave, Portland, OR 97215-3148 | 2020-09-16 |
| 1104446681 | Skycloud Psychiatry LLC | Nurse Practitioner | 106 South West Woods St, Portland, OR 97201 | 2020-04-24 |
| 1730712290 | Lucy Anne Bloedon | Nurse Practitioner | 4020 Sw Iowa St, Portland, OR 97221-3423 | 2020-02-12 |
| 1346802733 | Compass Psychiatric Wellness LLC | Nurse Practitioner | 4300 Ne Fremont St Ste 260, Portland, OR 97213-1100 | 2019-07-05 |
| 1548721871 | Cooke Therapy Pllc | Nurse Practitioner | 1125 Se Madison St Ste 102, Portland, OR 97214-3600 | 2019-03-28 |
| 1245719541 | Scott J Whited | Nurse Practitioner | 216 Vaughan St., Mcgeachy Hall, Portland, ME 04101 | 2018-08-08 |
| 1467969220 | Nw Mind-body Wellness, LLC | Nurse Practitioner | 16986 Nw Lynch Ln, Portland, OR 97229-1221 | 2018-01-02 |
| 1811441348 | Anthony Hoy | Nurse Practitioner | 5562 Se Pine St, Portland, OR 97215-1276 | 2016-08-12 |
| 1700241254 | Jacqueline J Cole | Nurse Practitioner | 5228 Ne Hoyt St Ste 300, Portland, OR 97213-3055 | 2015-12-29 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.