Peterson, Kim A

Peterson, Kim A is an sole proprietor health care provider with primary practice located at 610 Nw 11Th St , Hermiston OR 97838-6601. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Peterson, Kim A can be contacted via phone (541) 667-3439.

Contact Information

Primary practice address
610 Nw 11Th St Hermiston OR 97838-6601
Fax: (541) 667-3414
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X DO16339 Oregon

Profile Details

NPI number 1821028960
LBN Legal business name Peterson, Kim A
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 4th, 2006
Last updated Jul 8th, 2007 - about 19 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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Identifiers

StateTypeNumberIssuer
All States NPI 1821028960 NPPES
Oregon MEDICAID 077920

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