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

MS. Lacey Wise, PT

Individual provider Physical Therapist · NPI 1154830677

MS. Lacey Wise, PT is a Physical Therapist in Private Practice in Castle Rock, Washington. Qualified in 2017, 9 years ago. Practices with Centralia Physical Therapy Inc Ps, a 20-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Washington.

Years since qualifying
9
Licensed in
WA
In the registry since
2017
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

1316 Mt Saint Helens Way SE Ste B
Castle Rock, WA 98611
Phone: (360) 557-8020
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1817 S Market Blvd Ste C, Chehalis, WA 98532-4100 — (360) 996-4410

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT61342050 (WA)

Record details

NPI number1154830677
Entity typeIndividual (Type 1)
GenderFemale
Credentials PT
Sole proprietorNo
NPI enumeratedSeptember 27, 2017
Last updated in NPPESMarch 26, 2024
Certification dateMarch 22, 2024
Mailing address1817 S Market Blvd Ste C, Chehalis, WA 98532-4100

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Centralia Physical Therapy Inc Ps — 20 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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