Individual
KATRINA IRENE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1231 116TH AVE NE STE 515, BELLEVUE, WA 98004-3804
(425) 688-5000
Mailing address
1035 116TH AVE NE, BELLEVUE, WA 98004-4604
(425) 688-5000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP61452567
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
343601601
—
TX
01
—
387414YLLW
MEDICARE PTAN
TX
Enumeration date
08/18/2014
Last updated
10/16/2023
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