Individual
DR. DOMINIQUE JUSTIN PEPPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 LILLY RD NE STE 201, OLYMPIA, WA 98506
(360) 413-8272
(360) 413-8878
Mailing address
PO BOX 3360, PORTLAND, OR 97208-3360
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
MD60818088
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
796-L
MS. TEMPORARY MEDICAL LICENSE
MS
Enumeration date
10/08/2010
Last updated
06/23/2021
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