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Nickolas Justin Wise

Case Manager/Care Coordinator in Tacoma, WA. Individual provider (NPI-1).

NPI number1831735802
StatusActive
Last updated in NPPESNov 25, 2019

Details

NPI
1831735802
Entity type
Individual (NPI-1)
Name
Nickolas Justin Wise
Sex
Male
Sole proprietor
No
Enumeration date
Nov 25, 2019
Last updated
Nov 25, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
171M00000X Case Manager/Care Coordinator––Yes

Practice location

1159 Market St
Tacoma, WA 98402

Phone 253-552-5786

Mailing address

1159 Market St
Tacoma, WA 98402

Phone 253-552-5786

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