NPI 1043515224

Richard Petersen

Practitioner Pharmacist Longview, WA

Practice location

Address: 1227 15th Ave, Longview, WA 98632-3022
Phone: (360) 575-6606
Fax: (360) 575-6608

Registered specialties

Pharmacist Primary

Pharmacy Service Providers Taxonomy 183500000X Licence WA11429 (WA)

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Registry record

NPI: 1043515224
Entity type: Individual
Sex (as registered): Male
NPI issued: 19 Jan 2011
Record last updated: 19 Jan 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.