Individual
LINDSEY LOUISE PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3505 N WILLIAMS AVE, PORTLAND, OR 97227-1437
(971) 202-2910
Mailing address
1720 N NEW HAMPSHIRE AVE, TAVARES, FL 32778-2107
(352) 978-6970
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA200529
OR
363A00000X
Physician Assistant
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—
Other
Enumeration date
07/07/2020
Last updated
08/28/2020
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