Ryan C Petersen MD

NPI 1164513008 - Internal Medicine - 207R00000X

NPI Details
NPI 1164513008
Gender Male
Enumeration Date 09/27/2006
Last Updated 10/02/2014
Entity Type Individual
Active Over 10 years ago
Practice Location
1151 MAY ST
HOOD RIVER OR, 97031-1552, US
Phone (541) 399-7552
Fax
Business Location
PO BOX 3390
PORTLAND OR, 97208-3390, US
Phone
Fax
Toxanomy
Taxonomy Code 207R00000X
License State Oregon
License Number MD24586
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According to our database, Ryan C Petersen MD NPI is 1164513008, taxonomy code is 207R00000X and license number is MD24586, license state is located at Oregon. Ryan C Petersen MD physically located at 1151 May St, Hood River OR, 97031-1552. NPI Number Ryan C Petersen MD has the Individual type.

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1164513008 NPI number is provided on an as is basis without warranty of any kind. 1164513008 is maintained by the National Plan & Provider Enumeration System. The contents of Ryan C Petersen MD are for informational purposes only.