Petta, Matthew D.

Petta, Matthew D. is an sole proprietor health care provider with primary practice located at 628 Madison St , Port Townsend WA 98368-4414. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Petta, Matthew D. can be contacted via phone (402) 990-0733.

Contact Information

Primary practice address
628 Madison St Port Townsend WA 98368-4414
Phone: (402) 990-0733
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 60552041 Washington

Profile Details

NPI number 1376569954
LBN Legal business name Petta, Matthew D.
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 15th, 2006
Last updated Feb 12th, 2016 - about 8 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 1376569954 NPPES
Washington Other 1376569954 NPI

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