Individual
DR. KEVIN BRADLEY PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AU.D
Contact information
Practice address
21911 76TH AVE W STE 211, EDMONDS, WA 98026-7918
(425) 775-6651
Mailing address
21911 76TH AVE W STE 211, EDMONDS, WA 98026-7918
(425) 775-6651
(425) 670-6718
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
LD60889235
WA
237600000X
Audiologist-Hearing Aid Fitter
LD60889235
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2108044
—
WA
Enumeration date
09/25/2018
Last updated
10/05/2018
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