Peterson, Donald Leon

Peterson, Donald Leon is an individual health care provider with primary practice located at 813 Sw Highland Ave , Redmond OR 97756-3123. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Peterson, Donald Leon can be contacted via phone (541) 548-7170.

Contact Information

Primary practice address
813 Sw Highland Ave Redmond OR 97756-3123
Phone: (541) 548-7170
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 1290T Oregon

Profile Details

NPI number 1215939137
LBN Legal business name Peterson, Donald Leon
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 11th, 2005
Last updated Dec 17th, 2007 - about 18 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 1215939137 NPPES
Oregon MEDICAID 236067
Oregon Other A002

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