Individual
LEIF ERIC PETTERSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
1250 SW VETERANS WAY STE 120, REDMOND, OR 97756-2588
(541) 383-3005
(541) 383-1883
Mailing address
600 SW COLUMBIA ST STE 6250, BEND, OR 97702-1099
(541) 383-3005
(541) 383-1883
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
006253
CT
363LF0000X
Family Nurse Practitioner
Primary
202008709NP-PP
OR
Other
Enumeration date
09/24/2015
Last updated
01/18/2023
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