Individual
LISA PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
12629 SE 54TH ST, BELLEVUE, WA 98006-2916
(808) 780-5257
Mailing address
12629 SE 54TH ST, BELLEVUE, WA 98006-2916
(808) 780-5257
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP60267893
WA
Other
Enumeration date
01/25/2012
Last updated
01/25/2012
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