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Individual

MRS. KRISTINE MIKA PETERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
R.D.

Contact information

Practice address
1550 N 115TH ST, SEATTLE, WA 98133-8401
(206) 520-5000
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 520-5700

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
1033963
AZ
133V00000X
Registered Dietitian
Primary
DI60720921
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1023565355
WA
01
1033963
COMMITTEE ON DIETETIC REGISTRATION ID NUMBER
AZ
Enumeration date
09/02/2016
Last updated
05/03/2024
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