Individual
DR. PETER JOSEPH FOCHESATO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1600 ROOSEVELT AVE, SUITE A, MOUNT VERNON, WA 98273-2646
(360) 428-0304
(360) 428-0968
Mailing address
1600 ROOSEVELT AVE, SUITE A, MOUNT VERNON, WA 98273-2646
(360) 428-0304
(360) 428-0968
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
2301006668
MI
111N00000X
Chiropractor
2305-012
WI
111N00000X
Chiropractor
Primary
CH00002227
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
49111
L&I NUMBER
WA
01
—
8592FO
REGENCE RIDER NUMBER
WA
Enumeration date
11/17/2006
Last updated
07/09/2007
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