Petersen, Lisa Jo
Petersen, Lisa Jo is an individual health care provider with primary practice located at 933 Red Apple Rd Ste D Central Washington Hospital Women'S Healthcare Center, Wenatchee WA 98801-3370. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Petersen, Lisa Jo can be contacted via phone (509) 665-6125.Contact Information
Primary practice address
933 Red Apple Rd Ste D Central Washington Hospital Women'S Healthcare Center
Wenatchee WA 98801-3370
Phone: (509) 665-6125
Fax: (509) 665-6124
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | MD00033127 | Washington |
Profile Details
| NPI number | 1184620957 |
|---|---|
| LBN Legal business name | Petersen, Lisa Jo |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 24th, 2005 |
| Last updated | Jun 25th, 2010 - 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 | 1184620957 | NPPES |
| Washington | MEDICAID | 8192262 |
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