Individual
MS. GAIL A. PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP, FNP-BC
Contact information
Practice address
411 FORTUYN RD, GRAND COULEE, WA 99133-8718
(509) 633-1753
(509) 633-1933
Mailing address
707 S GRADY WAY STE 400, RENTON, WA 98057-3246
(509) 797-1889
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP30006440
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1022320
—
WA
01
—
G8900106
CMC MDCR PTAN
WA
Enumeration date
09/27/2006
Last updated
09/06/2023
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