Individual
DR. ALEX MICHAEL PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM. D
Contact information
Practice address
6720 NE 84TH ST, VANCOUVER, WA 98665-2016
(360) 828-2289
Mailing address
13717 NW 2ND AVE APT 64, VANCOUVER, WA 98685-1901
(702) 217-2135
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
12862
OR
183500000X
Pharmacist
Primary
17637
NV
183500000X
Pharmacist
18355
CO
183500000X
Pharmacist
PH 60196181
WA
Other
Enumeration date
03/13/2012
Last updated
03/13/2012
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