Individual
BRUCE E PETERSON
Active
Individual
BRUCE E PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00002292
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
113275
KAISER PERMANENTE
WA
01
—
179681
DEPARTMENT OF LABOR & IND
WA
05
—
8345589
—
WA
01
—
8930118
CRIME VICTIMS
WA
01
—
932823
FIRST HEALTH
WA
01
—
K465803
PACIFIC SOURCE
WA
Enumeration date
07/07/2005
Last updated
07/11/2007
Update your record
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