Individual
PATRICIA E PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2020 CAPITOL ST NE, SALEM, OR 97303-3244
(503) 399-2424
(503) 375-7429
Mailing address
PO BOX 8100, SALEM, OR 97303-0900
(503) 399-2424
(503) 375-7429
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD064647
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
064647
—
OR
01
—
160023207
RAILROAD MEDICARE
—
01
—
CS4159
RAILROAD GROUP
—
Enumeration date
06/12/2006
Last updated
05/27/2010
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