Individual
JOHN PATRICK D PERALTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MN, RN
Contact information
Practice address
25818 102ND PL SE, KENT, WA 98030-6409
(206) 204-5089
Mailing address
13157 175TH AVE E UNIT C1, BONNEY LAKE, WA 98391-7463
(253) 217-2086
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN60855020
WA
Other
Enumeration date
07/26/2023
Last updated
07/26/2023
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