Individual
MR. GEORGE PEDERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.P.T.
Contact information
Practice address
553 ROOSEVELT AVE, SUITE 101, ENUMCLAW, WA 98022-2990
(360) 825-1540
(360) 825-7434
Mailing address
553 ROOSEVELT AVE, SUITE 101, ENUMCLAW, WA 98022-2990
(360) 825-1540
(360) 825-7434
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8346462
—
WA
Enumeration date
11/29/2006
Last updated
11/29/2012
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