Individual
CRAIG M PETERSON
Active
Individual
CRAIG M PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00005023
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DB3601
RR MEDICARE GROUP #
WA
01
—
G8800296
MEDICARE GROUP NUMBER
WA
01
—
P00099837
RR MEDICARE
WA
Enumeration date
12/05/2006
Last updated
11/15/2013
Update your record
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