Individual
BRIAN S PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
151 NE STATE ROUTE 300, BELFAIR, WA 98528
(360) 275-8727
(360) 275-9695
Mailing address
PO BOX 370, BELFAIR, WA 98528-0370
(360) 275-8727
(360) 275-9695
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2694
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
192562400
OWCP
WA
05
—
2015212
—
WA
01
—
44709
LABOR AND INDUSTRIES
WA
01
—
PE0074
REGENCE
WA
Enumeration date
10/12/2006
Last updated
01/16/2025
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