Peterson, Glenda A
Peterson, Glenda A is an individual health care provider with primary practice located at 16110 Sw Regatta Ln , Beaverton OR 97006-8942. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Peterson, Glenda A can be contacted via phone (503) 629-2131.Contact Information
Primary practice address
16110 Sw Regatta Ln
Beaverton OR 97006-8942
Phone: (503) 629-2131
Fax: (503) 617-9379
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health | 363LP0808X | 079039861N6 | Oregon |
Profile Details
| NPI number | 1871516773 |
|---|---|
| LBN Legal business name | Peterson, Glenda A |
| Credentials | PMHN |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 25th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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 | 1871516773 | NPPES |
| Other | 115218 | MANAGED HEALTH |
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