Individual
PETER W DICRISTINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1230 7TH AVE, LONGVIEW, WA 98632-3198
(360) 636-2400
Mailing address
1230 7TH AVE, LONGVIEW, WA 98632-3198
(360) 636-2400
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00047879
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0440370
—
IA
Enumeration date
07/06/2005
Last updated
04/05/2026
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