Peterson, Kevin Bradley

Peterson, Kevin Bradley is an individual health care provider with primary practice located at 21911 76Th Ave W Ste 211 , Edmonds WA 98026-7918. He recently has 2 registered licenses in different health care specialties including Speech, Language and Hearing Service Providers / Audiologist-Hearing Aid Fitter, Speech, Language and Hearing Service Providers / Audiologist. Speech, Language and Hearing Service Providers / Audiologist is his primary health care specialty. Peterson, Kevin Bradley can be contacted via phone (425) 775-6651.

Contact Information

Primary practice address
21911 76Th Ave W Ste 211 Edmonds WA 98026-7918
Phone: (425) 775-6651
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Audiologist-Hearing Aid Fitter 237600000X LD60889235 Washington
Speech, Language and Hearing Service Providers / Audiologist 231H00000X LD60889235 Washington

Profile Details

NPI number 1215412317
LBN Legal business name Peterson, Kevin Bradley
Credentials AU.D
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 25th, 2018
Last updated Oct 5th, 2018 - about 6 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 1215412317 NPPES
Washington MEDICAID 2108044

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