Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jessie G Wise, CRM

Individual provider Peer Specialist · NPI 1174012041

Jessie G Wise, CRM is a Peer Specialist in LA Grande, Oregon. Licensed in Oregon. Registered with an NPI since 2018.

Licensed in
OR
In the registry since
2018
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Practice location Address checks out

1501 6th St
LA Grande, OR 97850-2419
Phone: (541) 962-0162
Fax: (541) 962-0162
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Peer Specialist (primary) Taxonomy 175T00000X · Licence 18-CRM-092 (OR)

Record details

NPI number1174012041
Entity typeIndividual (Type 1)
GenderMale
Credentials CRM
Sole proprietorNo
NPI enumeratedMay 7, 2018
Last updated in NPPESMay 7, 2018

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