Individual
MRS. KARISS CORENE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP, FNP-BC
Contact information
Practice address
550 17TH AVE STE 680, SEATTLE, WA 98122-5795
(206) 861-8550
(206) 861-8551
Mailing address
PO BOX 25608, SALT LAKE CITY, UT 84125-0608
(206) 320-4476
(206) 568-7043
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN60002263
WA
363LF0000X
Family Nurse Practitioner
Primary
AP60399126
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1982046298
—
WA
Enumeration date
07/28/2013
Last updated
02/03/2021
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