Individual
SAMANTHA PEDERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
336 CHARDONNAY AVE STE A, PROSSER, WA 99350-9515
(509) 786-1576
Mailing address
336 CHARDONNAY AVE, PROSSER, WA 99350-9515
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP61453730
WA
Other
Enumeration date
05/19/2023
Last updated
06/15/2023
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