Individual
DALE T PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
820 N CHELAN AVE, WENATCHEE, WA 98801-2028
(509) 663-8711
Mailing address
820 N CHELAN AVE, WENATCHEE, WA 98801-2028
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
MD00011841
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30724
L&I
WA
05
—
8209801
—
WA
Enumeration date
07/14/2006
Last updated
11/16/2011
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