Petersen, Christine Ann

Petersen, Christine Ann is an individual health care provider with primary practice located at 1333 E Barnett Rd , Medford OR 97504-8219. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Ophthalmology, Allopathic & Osteopathic Physicians / Glaucoma Specialist. Allopathic & Osteopathic Physicians / Glaucoma Specialist is her primary health care specialty. Petersen, Christine Ann can be contacted via phone (541) 779-4711.

Contact Information

Primary practice address
1333 E Barnett Rd Medford OR 97504-8219
Phone: (541) 779-4711
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X MD208212 Oregon
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X MD60943957 Washington
Allopathic & Osteopathic Physicians / Glaucoma Specialist 207WX0009X MD208212 Oregon

Profile Details

NPI number 1639580194
LBN Legal business name Petersen, Christine Ann
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 17th, 2014
Last updated Jul 18th, 2023 - about 2 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639580194 NPPES
Washington MEDICAID 1639580194
Washington MEDICAID 500765352

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