Individual
MS. KAREN A PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CHP, LMP
Contact information
Practice address
5505 BROOKLYN AVE NE, SEATTLE, WA 98105-3517
(206) 328-5143
(206) 525-5351
Mailing address
5505 BROOKLYN AVE NE, SEATTLE, WA 98105-3517
(206) 328-5143
(206) 525-5351
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00008947
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0107673
LABOR&INDUSTRIESPROVIDER#
WA
01
—
MA00008947
MASSAGE LICENCE #
WA
01
—
PE5492
REGENCEPROVIDER#
WA
Enumeration date
07/03/2007
Last updated
07/08/2007
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