Peterson, Larry Len
Peterson, Larry Len is an individual health care provider with primary practice located at 16877 65Th Ave , Lake Oswego OR 97035-7865. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Peterson, Larry Len can be contacted via phone (503) 620-3376.Contact Information
Primary practice address
16877 65Th Ave
Lake Oswego OR 97035-7865
Phone: (503) 620-3376
Fax: (503) 684-8554
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | MD12848 | Oregon |
Profile Details
| NPI number | 1043273907 |
|---|---|
| LBN Legal business name | Peterson, Larry Len |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 10th, 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 | 1043273907 | NPPES |
| Oregon | Other | 3542298 | LIFEWISE |
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