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Jessie G Wise, CRM
Peer Specialist in La Grande, Oregon
NPI 1174012041

Jessie G Wise is a Peer Specialist based in La Grande, OR. Jessie G Wise practices in La Grande, OR and has the professional credentials of CRM. The NPI Number for Jessie G Wise is 1174012041 and holds a License No. 18-CRM-092 (Oregon).

The current practice location address for Jessie G Wise is 1501 6Th St, La Grande, OR and can be reached out via phone at 541-962-0162 and via fax at 541-962-0162.

Location: 1501 6Th St, La Grande, OR, 97850-2043
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1174012041
Provider Name
Jessie G Wise
Credential
CRM
Provider Entity Type
Individual
Gender
Male
Address
1501 6Th St, La Grande, OR, 97850-2043
Phone Number
541-962-0162
Fax Number
541-962-0162
Provider Enumeration Date
05/07/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1501 6Th St
City
La Grande
State
Oregon
Zip
97850-2419
Phone Number
541-962-0162
Fax Number
541-962-0162
person
Provider Business Mailing Address Details
Address
1501 6Th St
City
La Grande
State
Oregon
Zip
97850-2419
Phone Number
541-962-0162
Fax Number
541-962-0162
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
18-CRM-092 (Oregon)
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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