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Individual

DR. PRESTON LANE PETERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2701 NW VAUGHN ST, SUITE 160, PORTLAND, OR 97210-5311
(503) 499-5200
(503) 499-5455
Mailing address
2701 NW VAUGHN ST, SUITE 160, PORTLAND, OR 97210-5311
(503) 499-5200
(503) 499-5455

Taxonomy

Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
MD25733
OR
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
MD60167468
WA

Other

Enumeration date
01/26/2006
Last updated
02/04/2022
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