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Individual

NEAL J. PETERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
510 S COWLEY ST, SPOKANE, WA 99202-1332
(509) 838-2531
Mailing address
PO BOX 3649, SPOKANE, WA 99220-3649

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD00048100
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0222004
L&I
WA
05
8484289
WA
Enumeration date
05/24/2007
Last updated
12/15/2008
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