| Doctor Name: | DR. PERRY JOE WISE |
| NPI Number: | 1033342720 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | N.D. |
| License Number: | NT00000808 |
| Business Practice Address: | 723 Ballentine St Raymond, WA - 985773603 |
| Business Phone Number: | 3605812252 |
| Business Fax Number: | |
| Mailing Address: | Po Box 308, Healing Heart & Hands SOUTH BEND |
| State: | WA |
| Postal Code: | 985860308 |
| Phone Number: | 3605812252 |
| Fax Number: | |
| NPI Enumeration Date: | 08/27/2009 |
| NPI Last Update Date: | 08/27/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | NT00000808 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |