Individual
GARRETT PARKER PERESKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
531 ADAMS AVE, MORTON, WA 98356-9323
(360) 496-5145
Mailing address
PO BOX 1138, MORTON, WA 98356-0019
(360) 496-5112
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PO61185768
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
PA
Other
Enumeration date
05/09/2018
Last updated
09/24/2021
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