Individual
DR. CHRISTINE ANN PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1333 E BARNETT RD, MEDFORD, OR 97504-8219
(541) 779-4711
Mailing address
1333 E BARNETT RD, MEDFORD, OR 97504-8219
(206) 520-5700
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
MD208212
OR
207W00000X
Ophthalmology Physician
MD60943957
WA
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
Primary
MD208212
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1639580194
—
WA
05
—
500765352
—
OR
Enumeration date
05/17/2014
Last updated
07/18/2023
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