Individual
JOHN E PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
700 LILLY RD NE, OLYMPIA, WA 98506-5115
(360) 923-7000
Mailing address
PO BOX 34584, SEATTLE, WA 98124-1584
(509) 241-7349
(509) 241-7628
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD00000923
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2013993
—
WA
Enumeration date
03/29/2007
Last updated
01/17/2008
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