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General NPI Number Information
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NPI Number | 1770021008
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Entity Type | Individual
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Provider Name | PETER AUSTIN NORKUS LSWAIC
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Gender | Male
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Dates
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Enumeration Date | 02/07/2017
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Last Update Date | 02/07/2017
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Provider Practice Location Address
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Address Line | 1700 WESTLAKE AVE N SUITE 700
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City | SEATTLE
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State | WA
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Zip | 98109-3012
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Country | US
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Telephone | 206-283-2220
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Fax |
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Provider Business Mailing Address
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Address Line | 125 SW CAMPUS DR APT 6-104
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City | FEDERAL WAY
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State | WA
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Zip | 98023-8365
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Country | US
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Telephone | 616-558-6606
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | SC 60635149
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License Number State | WA
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