Peterson, Patricia J.

Peterson, Patricia J. is an individual health care provider with primary practice located at 1615 Delaware St , Longview WA 98632-2367. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Peterson, Patricia J. can be contacted via phone (360) 501-3601.

Contact Information

Primary practice address
1615 Delaware St Longview WA 98632-2367
Phone: (360) 501-3601
Fax: (360) 501-3648
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD00017283 Washington

Profile Details

NPI number 1992706436
LBN Legal business name Peterson, Patricia J.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 9th, 2005
Last updated Jul 30th, 2012 - about 13 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 1992706436 NPPES
Oregon MEDICAID 218636
Oregon MEDICAID 8239071
Oregon Other 126459
Oregon Other 110194835
Oregon Other 8923175

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