Petersen, Iris Havlina Donovan

Petersen, Iris Havlina Donovan is an individual health care provider with primary practice located at 3434 12Th Ave Ne , Olympia WA 98506-5175. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Petersen, Iris Havlina Donovan can be contacted via phone (360) 413-8470.

Contact Information

Primary practice address
3434 12Th Ave Ne Olympia WA 98506-5175
Phone: (360) 413-8470
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 11405455-1205 Utah
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD61140296 Washington

Profile Details

NPI number 1659868560
LBN Legal business name Petersen, Iris Havlina Donovan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 16th, 2018
Last updated Aug 8th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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