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NPI Code Detail

MEDICARE: MEGAN RENEE PETERSON AAS-HIS

MEDICARE:   MEGAN RENEE PETERSON  AAS-HIS
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
1237700000XHearing Instrument SpecialistHA 60206077WA

General Provider Information

NPI Number : 1003191024
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEGAN RENEE PETERSON AAS-HIS
Provider Business Mailing Address
First Line : 1107 N ADKINS DR
Second Line :
City : POST FALLS
State : ID
Zip : 83854-9056
Country : US
Telephone Number : 208-446-7679
Fax Number :
Provider Business Practice Location Address
First Line : 9211 E MISSION AVE STE G
Second Line :
City : SPOKANE VALLEY
State : WA
Zip : 99206-4096
Country : US
Telephone Number : 509-323-9229
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/21/2011
Last Update Date : 10/21/2011

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Directions to “ MEGAN RENEE PETERSON AAS-HIS” Practice Location

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