Individual
MRS. MICHELE JENNEFER PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.M.P.
Contact information
Practice address
34730 PACIFIC HWY S, FEDERAL WAY, WA 98003-6821
(253) 874-0198
(253) 874-0408
Mailing address
918 SW 314TH PL, FEDERAL WAY, WA 98023-4523
(253) 945-0609
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00022514
WA
Other
Enumeration date
12/04/2006
Last updated
07/08/2007
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