Individual
DR. IRIS HAVLINA DONOVAN PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3434 12TH AVE NE, OLYMPIA, WA 98506-5175
(360) 413-8470
Mailing address
3434 12TH AVE NE, OLYMPIA, WA 98506-5175
(360) 413-8470
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
11405455-1205
UT
208000000X
Pediatrics Physician
Primary
MD61140296
WA
Other
Enumeration date
04/16/2018
Last updated
08/08/2021
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