Peterson, Shane Michael

Peterson, Shane Michael is an individual health care provider with primary practice located at 3300 19Th Avenue , Forest Grove OR 97116. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Peterson, Shane Michael can be contacted via phone (503) 357-7119.

Contact Information

Primary practice address
3300 19Th Avenue Forest Grove OR 97116
Phone: (503) 357-7119
Fax: (503) 992-2097
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 06407 Oregon

Profile Details

NPI number 1336445535
LBN Legal business name Peterson, Shane Michael
Credentials D.P.T.
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 4th, 2011
Last updated Feb 4th, 2011 - 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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