Individual
DONALD PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA-P
Contact information
Practice address
4205 ARBOR CT SE, LACEY, WA 98503-4040
(760) 885-3865
Mailing address
4205 ARBOR CT SE, LACEY, WA 98503-4040
(760) 885-3865
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
CPT0009753
CA
246RP1900X
Phlebotomy Technician
Primary
PC60519119
WA
251J00000X
Nursing Care Agency
NA61263271
WA
Other
Enumeration date
04/22/2026
Last updated
04/22/2026
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