Individual
SAMUEL R. PETTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
742B BOYLSTON AVE E, SEATTLE, WA 98102-4619
(000) 000-0000
Mailing address
742B BOYLSTON AVE E, SEATTLE, WA 98102-4619
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
MD00017597
WA
Other
Enumeration date
04/10/2006
Last updated
11/26/2007
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