Doctor Name: | DENISE J PETERSON |
NPI Number: | 1194810572 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMP |
License Number: | MA00011739 |
Business Practice Address: | 1222 Bronson Way N Suite 100 Renton, WA - 980551762 |
Business Phone Number: | 4252282824 |
Business Fax Number: | 4252286956 |
Mailing Address: | 1222 Bronson Way N, Suite 100 RENTON |
State: | WA |
Postal Code: | 980551762 |
Phone Number: | 4252282824 |
Fax Number: | 4252286956 |
NPI Enumeration Date: | 10/03/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | MA00011739 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |