IndividualActive
Keith Petersen, DO
NPI 1356615470 · Adult Medicine Physician · Tacoma, WA
Provider details
- NPI number
- 1356615470
- Entity type
- Individual
- Primary specialty
- Adult Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- DO
- Sex
- Male
- Sole proprietor
- No
- License
- 60595760 (WA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
9040 Jackson Ave
Tacoma, WA 98431-1000
Phone: (253) 968-1340
Approximate (ZIP-level) locationGet directions
Mailing address
9040 Jackson Ave 9040 Jackson Street
Tacoma, WA 98431-1000
Registry dates
- Enumerated
- 2012-03-07
- Last updated
- 2024-03-12
- Certified
- 2024-03-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.