Individual
MS. DIANE LESLIE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
1530 BELLEVUE WAY SE, STE C, BELLEVUE, WA 98004-7110
(425) 785-5608
Mailing address
1530 BELLEVUE WAY SE, SUITE C, BELLEVUE, WA 98004-7110
(425) 818-0086
(425) 818-5224
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA60129832
WA
Other
Enumeration date
08/27/2012
Last updated
08/29/2012
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