Individual
PETER WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
2474 SW PERKINS AVE, PENDLETON, OR 97801-4302
(541) 966-6638
(541) 276-6327
Mailing address
PO BOX 1517, PENDLETON, OR 97801-0410
(877) 708-1119
(541) 278-8349
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
10002005
OR
Other
Enumeration date
01/05/2023
Last updated
01/05/2023
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