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1831735802
NICKOLAS JUSTIN WISE
TACOMA, WA
NPI
1831735802
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2019-11-25
Last Update Date
2019-11-25
Business Address
NICKOLAS JUSTIN WISE
1159 MARKET ST
TACOMA, WA 98402
Phone number: 253-552-5786
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Mailing Address
NICKOLAS JUSTIN WISE
1159 MARKET ST
TACOMA, WA 98402
Phone number: 253-552-5786
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