Individual
GEORGE PETZINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
918 E MEAD AVE, YAKIMA, WA 98903-3720
(509) 453-1344
(509) 453-2209
Mailing address
402 N 4TH STREET, SUITE 202, YAKIMA, WA 98901
(509) 248-3782
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
MD00038547
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
139616
L & I
WA
01
—
8254252
CHPW
WA
05
—
8254252
—
WA
01
—
911019392
COMMERCIAL
—
Enumeration date
10/12/2006
Last updated
11/28/2011
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