Individual
MS. VANESSA IRENE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1911 MOUNTAIN VIEW LANE, SUITE 300, FOREST GROVE, OR 97116
(503) 357-2826
(503) 357-4831
Mailing address
333 NORTH 19TH AVE, CORNELIUS, OR 97113
(503) 430-0091
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
12894
OR
Other
Enumeration date
03/28/2007
Last updated
07/08/2007
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