Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 1313 | WA |
NPI | 1083752117 |
---|---|
Provider Name | Dr. Jena Marie Peterson |
First Address | Seattle, WA 98115-6934 |
Second Address | Seattle, WA 98115-6934 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2007 |
Last Update Date | 08/07/2007 |