Individual
TREY SPENCER PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
605 S COOLIDGE ST, MOSES LAKE, WA 98837-1873
(509) 765-0674
Mailing address
21 H ST NE, QUINCY, WA 98848-1079
(509) 237-3232
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
09/24/2024
Last updated
09/24/2024
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