KEITH E PETERSEN DO NPI 1356615470

NPI Information

Keith E Petersen, DO is a general practice in Tacoma, WA. Keith E Petersen, DO NPI is 1356615470. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

9040 JACKSON AVE
TACOMA, WA
ZIP 98431-000
Phone: (253) 968-1340

The NPI 1356615470 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/7/2012 and was last updated on 3/17/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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