Individual
DR. PETER M MIKKELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
835 SE BISHOP BLVD, PULLMAN, WA 99163-5512
(509) 336-7388
(509) 336-7389
Mailing address
835 SE BISHOP BLVD, PULLMAN, WA 99163-5512
(509) 336-7388
(509) 336-7389
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD00042890
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1019013
—
WA
05
—
1790745792
—
WA
05
—
500601704
—
OR
Enumeration date
03/24/2006
Last updated
07/14/2025
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