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Individual

MS. DEBORAH A PETERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.T.

Contact information

Practice address
6821 N COUNTRY HOMES BLVD, SUITE 102, SPOKANE, WA 99208-4372
(509) 325-6776
(509) 325-0817
Mailing address
16083 SW UPPER BOONES FERRY RD STE 300, TIGARD, OR 97224-7736
(800) 219-8835
(503) 639-9699

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
PT2996
WA
225100000X
Physical Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0038860
STATE L&I
WA
01
650010188
RAILROAD MEDICARE
01
GAB37906
MEDICARE PROVIDER
Enumeration date
03/24/2006
Last updated
04/13/2015
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