Individual
MISS TRASANDRA A PETERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
1500 FAIRVIEW AVE E STE 205, SEATTLE, WA 98102-3727
(360) 878-1633
Mailing address
1500 FAIRVIEW AVE E STE 205, SEATTLE, WA 98102-3727
(360) 878-1633
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00022813
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0211609
DEPT OF L & I
WA
Enumeration date
10/12/2006
Last updated
11/17/2017
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