Individual
MRS. LISA K PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
2748 MILTON WAY, SUITE 211, MILTON, WA 98354-9382
(253) 208-3477
(253) 943-5295
Mailing address
2748 MILTON WAY, SUITE 211, MILTON, WA 98354-9382
(253) 208-3477
(253) 943-5295
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00015263
WA
Other
Enumeration date
02/01/2007
Last updated
07/08/2007
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