Individual
PETER N. NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5633 N. LIDERGERWOOD, SPOKANE, WA 99208
(509) 482-0111
Mailing address
5633 N LIDGERWOOD ST, SPOKANE, WA 99208-1224
(509) 482-2448
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
000020435
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10097730
MDC RR #
WA
05
—
8570301
—
WA
05
—
9611674
—
WA
01
—
G000362001
MDC PIN #
WA
01
—
MD00020435
LICENCE
WA
Enumeration date
01/29/2007
Last updated
03/07/2023
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