Individual
BONNIE LOUISE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
412 LILLY RD NE, OLYMPIA, WA 98506-5132
(360) 867-2543
(360) 867-2601
Mailing address
412 LILLY RD NE, OLYMPIA, WA 98506-5132
(360) 867-2543
(360) 867-2601
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
RN00056442
WA
163WP0200X
Pediatric Registered Nurse
RN00056442
WA
Other
Enumeration date
07/12/2012
Last updated
07/12/2012
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