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NPI Code Detail

MEDICARE: JULI PETERS LMP LMT

MEDICARE:   JULI  PETERS  LMP   LMT
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
1174400000XSpecialistMA00014146WA

General Provider Information

NPI Number : 1053459479
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULI PETERS LMP LMT
Provider Business Mailing Address
First Line : 4704 NE 50TH AVE
Second Line :
City : VANCOUVER
State : WA
Zip : 98661-2857
Country : US
Telephone Number : 360-690-1358
Fax Number : 360-737-8337
Provider Business Practice Location Address
First Line : 410 E 20TH ST
Second Line :
City : VANCOUVER
State : WA
Zip : 98663-3316
Country : US
Telephone Number : 360-690-1358
Fax Number : 360-737-8337
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2007
Last Update Date : 07/08/2007

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Directions to “ JULI PETERS LMP LMT” Practice Location

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