Organization
PETERSEN INVESTMENTS, LLC
Active
Other names
Columbia Compounding
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTOPHER PETERSEN PHARMD (MANAGING MEMBER)
(360) 261-9040
Entity
Organization
Contact information
Practice address
12119 NE 99TH ST STE 2030, VANCOUVER, WA 98682-2461
(360) 217-4250
(360) 230-1919
Mailing address
12119 NE 99TH ST STE 2030, VANCOUVER, WA 98682-2461
(360) 217-4250
(360) 230-1919
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
Primary
—
—
Other
Enumeration date
12/04/2019
Last updated
02/21/2020
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