Search › Washington › 363A00000X
Glenn Peterson, PA-C
NPI 1972031698 · on the registry since 2017
Practice
- Address
- 19835 10th Ave Ne Ste B
Poulsbo, WA 98370 - Phone
- (360) 779-7011
- Clinicians at this address
- 2
Additional practice sites
- 412 S. Jackson St., Belleville, IL
- 939 Caroline St, Port Angeles, WA
- 4500 Memorial Dr, Belleville, IL
Registry record
- Primary taxonomy
- 363A00000X
363A00000X
- Also registered as
- 363A00000X
363A00000X - Licence states on file
- IL, WA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2022-07-21
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Washington