Individual
TINA LYNN LOUIE PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
505 NE 87TH AVE, SUITE 46.5, VANCOUVER, WA 98664-1989
(360) 828-5396
(360) 828-5455
Mailing address
505 NE 87TH AVE, SUITE 46.5, VANCOUVER, WA 98664-1989
(360) 828-5396
(360) 828-5455
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP60637603
WA
Other
Enumeration date
03/17/2016
Last updated
04/26/2016
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