Individual
MS. LISE MARY PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
17401 135TH AVE NE, SUITE 4, WOODINVILLE, WA 98072-6825
(425) 483-5454
(425) 424-3256
Mailing address
17401 135TH AVE NE, SUITE 4, WOODINVILLE, WA 98072-6825
(425) 483-5454
(425) 424-3256
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00012465
WA
Other
Enumeration date
03/09/2007
Last updated
07/08/2007
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