MEDICARE: PATRICK C PETERSON PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA10003923	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0212972	OTHER	WA	L&I
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437260171
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICK C PETERSON PA-C

Provider Business Mailing Address
First Line	:	PO BOX 3649
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99220-3649
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1326 N STANFORD LN
Second Line	:
City	:	LIBERTY LAKE
State	:	WA
Zip	:	99019-5034
Country	:	US
Telephone Number	:	509-838-2531
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	12/12/2011

Similar Medicare Providers

1437142585 — ALLEN R SEELY MD
Practice Location Address:

1326 N STANFORD LN
LIBERTY LAKE, WA
99019-5034

Practice Phone: 509-838-2531
Practice Fax:

1992755417 — ADAM STEVEN BROWN PHYSICAL THERAPIST
Practice Location Address:

1326 N STANFORD LN
LIBERTY LAKE, WA
99019-5034

Practice Phone: 509-838-2531
Practice Fax:

1306927892 — DR. JARED DEAN EVANS D.M.D.
Practice Location Address:

1327 N STANFORD LN , SUITE B
LIBERTY LAKE, WA
99019-5034

Practice Phone: 509-891-7070
Practice Fax: 509-891-4741

1093128027 — DR. BENJAMIN WELLS JADERHOLM D.O.
Practice Location Address:

1326 N STANFORD LN
LIBERTY LAKE, WA
99019-5034

Practice Phone: 509-838-2531
Practice Fax: 509-755-6580

1699174383 — ROCKWOOD CLINIC PS
Practice Location Address:

1326 N STANFORD LN
LIBERTY LAKE, WA
99019-5034

Practice Phone: 509-755-6760
Practice Fax: 509-755-6797

1427450535 — JAN NELSON NP-C, DBA, BALANCED WELLNESS MEDICAL CLINIC
Practice Location Address:

1328 N STANFORD LN , 101
LIBERTY LAKE, WA
99019-5034

Practice Phone: 509-891-7119
Practice Fax:

Directions to “ PATRICK C PETERSON PA-C” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.