Individual
MITCHELL JAY PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9709 3RD AVE NE, SEATTLE, WA 98115-2062
(206) 525-5777
(206) 528-9881
Mailing address
PO BOX 5127, EVERETT, WA 98206-5127
(206) 860-5414
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00031099
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1088640
—
WA
Enumeration date
06/14/2006
Last updated
01/26/2026
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