# PETER FORBER VANDERVEN PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** South Sound Oral Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1831142827
- **Authorized official:** MS. SANDRA LOUISE HARRELSON (FINANCIAL COORDINATOR)
- **Authorized official phone:** (253) 874-2583

## Contact information

- **Practice address:** 34709 9TH AVE S, SUITE B-300, FEDERAL WAY, WA 98003-8722
- **Practice address phone:** (253) 874-2583
- **Practice address fax:** (253) 874-8957
- **Mailing address:** 34709 9TH AVE S, SUITE B-300, FEDERAL WAY, WA 98003-8722
- **Mailing address phone:** (253) 874-2583
- **Mailing address fax:** (253) 874-8957

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 602515196 | WA | Yes |

## Other

- **Enumeration date:** 05/18/2006
- **Last updated:** 03/25/2013