IndividualActive
Anne Wisbey
NPI 1194049254 · Mental Illness Community Based Residential Treatment Facility · Wallowa, OR
Provider details
- NPI number
- 1194049254
- Entity type
- Individual
- Primary specialty
- Mental Illness Community Based Residential Treatment FacilityResidential Treatment Facilities
- Sex
- Female
- Sole proprietor
- Yes
- License
- 3111521345 (OR)
Specialties & taxonomies
- Mental Illness Community Based Residential Treatment FacilityPrimary320800000XLicense 3111521345 (OR)
Residential Treatment Facilities
Practice location
104 South Alder St.
Wallowa, OR 97885
Phone: (541) 886-3039
Fax: (541) 886-3039
Approximate (ZIP-level) locationGet directions
Mailing address
P O Box 5
Wallowa, OR 97885
Registry dates
- Enumerated
- 2010-03-18
- Last updated
- 2010-03-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.