Individual
JOSHUA M PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.ED, LAT, ATC
Contact information
Practice address
342 SW 16TH ST, CHEHALIS, WA 98532-3809
(360) 807-7235
Mailing address
217 FENWAY DR, CHEHALIS, WA 98532-7904
(206) 353-8850
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
60863058
WA
Other
Enumeration date
02/20/2018
Last updated
06/07/2021
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