Individual
MR. JON T PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1213 24TH ST STE 100, ANACORTES, WA 98221-2595
(360) 293-3101
Mailing address
4804 SUNSET BEACH DRIVE NW, OLYMPIA, WA 98502
(360) 867-0595
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OP00001517
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2007PE
BLUESHIELD FEDERAL
—
01
—
3568326
AETNA HMO
—
01
—
50D1031645
CLIA
—
01
—
5617199
AETNA NON HMO
—
01
—
601371600
US DEPT OF LABOR
—
01
—
8192247
DSHS
—
01
—
A1820
PREMERA HEALTH
—
01
—
A1825
PREMERA LIFEWISE
—
01
—
O186018
L & I
—
01
—
OP00001517
WA STATE LICENSE
—
Enumeration date
10/17/2006
Last updated
03/07/2023
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us