Individual
CLEA PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
9119 MIL PARK DRIVE, FORT LEWIS, WA 98433
(253) 966-9960
Mailing address
9119 MIL PARK DRIVE, FORT LEWIS, WA 98433
(253) 966-9960
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
000905422
CO
Other
Enumeration date
07/06/2016
Last updated
07/06/2016
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