Individual
MATTHEW S. PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
103 N. 1ST STREET, ELMA, WA 98541-0656
(360) 482-5155
(360) 482-4155
Mailing address
PO BOX 656, ELMA, WA 98541-0656
(360) 482-5155
(360) 482-4155
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
295378-1202
UT
111N00000X
Chiropractor
Primary
CH00003029
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2020535
—
WA
Enumeration date
04/09/2008
Last updated
06/12/2008
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