Individual
PETER K BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8716 E MILL PLAIN BLVD, VANCOUVER, WA 98664-2531
(360) 514-4325
(360) 514-4336
Mailing address
8716 E MILL PLAIN BLVD, VANCOUVER, WA 98664-2531
(360) 514-4325
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD61439872
WA
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
MD24481
OR
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
Primary
MD61439872
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
227426
—
OR
01
—
P00464800
RR MEDICARE
OR
Enumeration date
06/28/2006
Last updated
06/26/2025
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