MR. JON T PETERSON (NPI# 1669553723) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669553723 |
| Entity Type | Individual |
| Full Name | MR. JON T PETERSON |
| Credential | DO |
| Practice Address |
2960-a Limited Lane Nw Olympia WA 98502 |
| Mailing Address |
4804 Sunset Beach Drive Nw Olympia WA 98502 |
| Practice Telephone | 3607099500 |
| Practice Fax Number | 3607544517 |
| Mailing Telephone | 3608670595 |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2013-01-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | OP00001517 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PREMERA LIFEWISE | A1825 | 01 | |
| DSHS | 8192247 | 01 | |
| L & I | O186018 | 01 | |
| REGENCE BLUESHIELD | 2007PE | 01 | |
| PREMERA DIMENSIONS | A1820 | 01 | |
| US DEPT OF LABOR | 601371600 | 01 | |
| PREMERA BLUE CROSS | A1820 | 01 | |
| WA STATE LICENSE | OP00001517 | 01 | |
| AETNA HMO | 3568326 | 01 | |
| DEA | BP4916740 | 01 | |
| BLUESHIELD FEDERAL | 2007PE | 01 | |
| CLIA | 50D1031645 | 01 | |
| AETNA NON HMO | 5617199 | 01 | |
| PREMERA HEALTH | A1820 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952524324 | Jon Douglas Peterson | Psychiatry & Neurology | 1035 San Pablo Ave Ste 5, Albany, CA 94706-2276 | 2007-04-11 |
| 1265593560 | Jon B Peterson | Chiropractor | 2611 Clearwater Rd, Saint Cloud, MN 56301-5953 | 2006-12-12 |
| 1285726380 | Jon E Peterson | Dentist | 4076 3rd Ave # Su.201, San Diego, CA 92103-2129 | 2006-09-28 |
| 1285112482 | Jon Peterson | Behavioral Analyst | 85 Stoneheights Dr, Waterford, CT 06385-1975 | 2018-07-31 |
| 1063645893 | Jon Tor Peterson | Pharmacist | 9983 Wadsworth Pkwy, Westminster, CO 80021-4249 | 2009-08-27 |
| 1407870975 | Jon T Peterson | Emergency Medicine | 2871 Greensboro Rd, Martinsville, VA 24112-8108 | 2006-07-27 |
| 1972549236 | Jon W Peterson | Psychologist | 25401 Cabot Rd, Suite 213, Laguna Hills, CA 92653-5524 | 2006-06-22 |
| 1043250640 | Jon Lee Peterson | Family Medicine | 0310c County Road 14, Del Norte, CO 81132-8719 | 2006-06-08 |
| 1508832676 | Jon Deep Peterson | Podiatrist | 101 Willmar Ave Sw, Willmar, MN 56201 | 2006-02-27 |
| Street Address |
2960-A LIMITED LANE NW |
| City | OLYMPIA |
| State | WA |
| Zip Code | 98502 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558446211 | South Sound Family & Sports | Family Medicine | 2960-a Limited Lane Nw, Olympia, WA 98502-4541 | 2006-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801409172 | Fanny Cordero | Interpreter | 1415 4th Ave W, Olympia, WA 98502 | 2020-08-26 |
| 1235762832 | Accessible Living Physical Therapy | Clinic/Center | 3524 7th Ave Se, Olympia, WA 98502 | 2020-02-21 |
| 1548807738 | Kaiser Foundation Health Plan of Washington | Pharmacy | 1200 Cooper Point Road Sw, Suite 100, Olympia, WA 98502 | 2019-12-06 |
| 1851946388 | Katherine Ann Vitela | Registered Nurse | 4909 Green Wood Dr Sw, Olympia, WA 98502 | 2019-08-01 |
| 1538632658 | Carmen Rae Breding | Massage Therapist | 2627 Capital Mall Dr Se, Olympia, WA 98502 | 2019-01-11 |
| 1285129155 | Fook Yee Cheung | Genetic Counselor, MS | 2010 Caton Way Sw Ste 102, Olympia, WA 98502 | 2018-06-24 |
| 1942724158 | William Coburn | Specialist/Technologist | 703 Lilly Road Ne, Suite 104, Olympia, WA 98502 | 2017-07-29 |
| 1225567415 | Thierry Buckner | Counselor | 2400 Bristol Court Sw, Olympia, WA 98502 | 2017-06-09 |
| 1619406048 | Trenton Reid | Massage Therapist | 2103 Harrison Ave Nw #2642, Olympia, WA 98502 | 2017-06-08 |
| 1962807305 | Richa Mehta | Dentist | 1530 Black Lake Boulevard, Suite A103, Olympia, WA 98502 | 2014-10-28 |
| Find all providers in zip 98502 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154974368 | Unruhly Medicine Pllc | Family Medicine | 1701 4th Ave E, Olympia, WA 98506-4533 | 2019-07-17 |
| 1104340405 | Sweet Medical Group, Pllc | Family Medicine | 8315 Normandy St Se, Olympia, WA 98504-0001 | 2017-07-28 |
| 1184144768 | Trevor Shane Kwan | Family Medicine | 525 Lilly Road Ne, Olympia, WA 98506 | 2017-06-23 |
| 1285018432 | South Sound Medical Group, Pllc | Family Medicine | 10116 Coachman Ln Se, Olympia, WA 98501-9731 | 2015-07-17 |
| 1710378229 | Mary Gibbons | Family Medicine | 7040 Puget Beach Rd Ne, Olympia, WA 98516-9158 | 2015-02-05 |
| 1588095749 | Coral Hilby | Family Medicine | 2520 Island Dr Nw, Olympia, WA 98502-9749 | 2013-12-12 |
| 1053756999 | Anna Maria A. Pletz | Family Medicine | 525 Lilly Rd Ne # 250, Pmg Sw Wa East Olympia Fam Med, Olympia, WA 98506-5101 | 2013-05-06 |
| 1811330673 | Eugen Sine Enterprises Inc | Family Medicine | 2121 Stillwater Ave Nw, Olympia, WA 98507 | 2013-04-11 |
| 1972877736 | Eric Richard Houghton | Family Medicine | 1832 Lakewood Cir Se, Olympia, WA 98501-4291 | 2012-02-25 |
| 1073828976 | Lacambra Services Inc | Family Medicine | 7205 Martin Way E, Suite A-69, Olympia, WA 98516-5555 | 2010-08-16 |
| Find all providers in OLYMPIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.