Peterson, Jolyon David
Peterson, Jolyon David is an individual health care provider with primary practice located at 1501 Pacific Ave , Tacoma WA 98402-3302. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Peterson, Jolyon David can be contacted via phone (253) 680-6016.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 12819 | Washington |
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | MD00012819 | Washington |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | MD00012819 | Washington |
Profile Details
| NPI number | 1093773160 |
|---|---|
| LBN Legal business name | Peterson, Jolyon David |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 1st, 2006 |
| Last updated | Mar 17th, 2015 - about 9 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 | 1093773160 | NPPES |
| Washington | MEDICAID | 8288003 |
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