# PETERSEN AND WELLER DDS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417960782
- **Authorized official:** MS. MICHELLE MARIE BEYER (FINANCIAL COORDINATOR)
- **Authorized official phone:** (425) 485-6540

## Contact information

- **Practice address:** 22833 BOTHELL EVERETT HWY SE, STE \#205, BOTHELL, WA 98021
- **Practice address phone:** (425) 485-6540
- **Practice address fax:** (425) 486-1740
- **Mailing address:** 22833 BOTHELL EVERETT HWY SE, STE \#205, BOTHELL, WA 98021
- **Mailing address phone:** (425) 485-6540
- **Mailing address fax:** (425) 486-1740

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 5471 | WA | Yes |
| 1223G0001X | General Practice Dentistry | 8485 | WA | — |

## Other

- **Enumeration date:** 08/15/2006
- **Last updated:** 08/22/2020