Individual
DR. DONALD R. PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1321 COLBY AVENUE, PROVIDENCE EVERETT MEDICAL CENTER, EVERETT, WA 98206
(425) 261-2000
Mailing address
728 134TH ST SW, SUITE 120, EVERETT, WA 98204-5322
(425) 297-6200
(425) 297-6250
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD00017156
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
115853
L&I PROVIDER NUMBER
WA
01
—
202192
L&I PROVIDER NUMBER
WA
01
—
202193
L&I PROVIDER NUMBER
WA
05
—
8197303
—
WA
01
—
P00368477
RR MEDICARE
WA
Enumeration date
01/05/2006
Last updated
12/07/2007
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