Individual
ANDREW PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
2902 164TH ST SW STE D1, LYNNWOOD, WA 98087-3201
(142) 574-5250
Mailing address
1323 E LENNOX PL, TACOMA, WA 98404-3827
(253) 985-7772
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
M60892308
WA
Other
Enumeration date
10/08/2020
Last updated
10/08/2020
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