Individual
PETER E BERTOZZI JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1001 KLICKITAT WAY SW, #205, SEATLE, WA 98134
(206) 622-7747
(206) 467-1470
Mailing address
PO BOX 34245, SEATTLE, WA 98124-1245
(206) 622-7747
(206) 467-1470
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
MD00014440
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
125694
ST LABOR AND INDUSTRIES
WA
05
—
8481905
—
WA
Enumeration date
11/15/2005
Last updated
06/21/2012
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