Petersen, Chris Albert
Petersen, Chris Albert is an individual health care provider with primary practice located at 875 Oak St Se Suite 5020, Salem OR 97301-3975. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Petersen, Chris Albert can be contacted via phone (503) 226-6321.Contact Information
Primary practice address
875 Oak St Se Suite 5020
Salem OR 97301-3975
Phone: (503) 226-6321
Fax: (503) 227-3422
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | PA00211 | Oregon |
Profile Details
| NPI number | 1952393241 |
|---|---|
| LBN Legal business name | Petersen, Chris Albert |
| Credentials | PAC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 22nd, 2005 |
| Last updated | Aug 19th, 2009 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1952393241 | NPPES |
| Oregon | MEDICAID | 210476 | |
| Oregon | MEDICAID | 8435877 |
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