Individual
ANDREA PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3710 SW US VETERANS HOSPITAL RD, PORTLAND, OR 97239-2964
(503) 220-8262
Mailing address
307 NE MONROE ST, PORTLAND, OR 97212-3048
(503) 334-5721
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
10006366
OR
Other
Enumeration date
11/17/2023
Last updated
11/17/2023
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