Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1598058786 Individual Practitioner Female Practitioner

Angelique Wise , LMT

Specialist • Tigard, OR

Professional Overview & Biography Verified Profile Summary

Angelique Wise, LMT is a registered healthcare professional specializing in Specialist in Tigard, OR. Practice services are available at 14340 SW 80TH PL under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

14340 Sw 80th Pl

Tigard, OR 972248162

Telephone 9712694080

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Tigard, OR

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 37.0 Yrs
State Avg: 35.7 Yrs
Regional Practice Density
28 Specialists

Practicing in Tigard, OR (1153 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

State License OR LMT#17875

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Secondary Practice Locations

14340 Sw 80th Pl

Portland, OR 972248162

Phone: 9712694080

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events
NPI Profile Active November 30, 2017

NPI status registered as active in NPPES database

📍
Updated Business Mailing Address November 30, 2017

Registered at 14340 SW 80TH PL, PORTLAND, OR 972248162 (Tel: 9712694080)

📍
Updated Practice Location November 30, 2017

Registered at 14340 SW 80TH PL, TIGARD, OR 972248162 (Tel: 9712694080)

👤
Provider Name / Credentials Updated November 30, 2017

Recorded as ANGELIQUE WISE, LMT

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 30, 2017

Specialist (License #LMT#17875 in OR)

NPI Profile Active May 20, 2011

NPI status registered as active in NPPES database

📍
Updated Practice Location May 20, 2011

Registered at 14340 SW 80TH PL, TIGARD, OR 972248162 (Tel: 9712694080)

📍
Updated Business Mailing Address May 20, 2011

Registered at 9045 SW BARBUR BLVD, SUITE 122, PORTLAND, OR 972194021 (Tel: 5032264500)

👤
Provider Name / Credentials Updated May 20, 2011

Recorded as ANGELIQUE WISE, LMT

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 20, 2011

Specialist (License #LMT#17875 in OR)

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Initial NPI Registration & Enumeration May 20, 2011

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1598058786
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 20, 2011
Last Update: March 17, 2018
Sole Proprietor: Yes

Mailing Address

14340 Sw 80th Pl

Portland, OR 972248162

Phone: 9712694080

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.