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Contact Information

LACEY WISE, PT
1316 MT SAINT HELENS WAY SE
SUITE B
CASTLE ROCK, WA98611
 Phone: 360-557-8020
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for LACEY WISE · (Female)

NPI # 1154830677
Status Active
Credentials PT (Physical Therapist)
Entity Individual
Enumeration date 09/27/2017
Last updated 03/26/2024 - About 2 years ago
Sole proprietor 1 No
Identifiers
  • WA License # PT61342050
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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