Individual
BRUCE D MCPETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3209 S 23RD ST, STE 340, TACOMA, WA 98405-1602
(253) 272-5127
Mailing address
15118 STARR PL SE, OLALLA, WA 98359-9549
(912) 673-6318
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP60202058
WA
367500000X
Certified Registered Nurse Anesthetist
RN096224
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G8885529
MDCR GRP PTAN
WA
01
—
G8885530
MDCR GRP PTAN (P)
WA
Enumeration date
04/04/2007
Last updated
01/05/2017
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