DR. KRISTOPHER M PETERS (NPI# 1891058145) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891058145 |
| Entity Type | Individual |
| Full Name | DR. KRISTOPHER M PETERS |
| Credential | D.O. |
| Practice Address |
9040 Jackson Ave Madigan Army Medical Center Tacoma WA 98431-4613 |
| Mailing Address |
9040 Jackson Ave Madigan Army Medical Center Tacoma WA 98431-0001 |
| Practice Telephone | 2539681365 |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2019-02-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 1048 | NE | Allopathic & Osteopathic Physicians |
| N | 208D00000X | General Practice | 1048 | NE | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
9040 JACKSON AVE MADIGAN ARMY MEDICAL CENTER |
| City | TACOMA |
| State | WA |
| Zip Code | 98431-4613 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386641694 | Muhammad Ayub | Family Medicine | 9040 Jackson Ave Madigan Army Medical Center, Tacoma, WA 98431-0001 | 2005-06-30 |
| 1699399659 | Haywood Maurice Mcrae | Social Worker | 9040 Jackson Ave Madigan Army Medical Center, Tacoma, WA 98431-0001 | 2020-06-04 |
| 1710490677 | Layne Jensen | Registered Nurse | 9040 Jackson Ave Madigan Army Medical Center, Attn: Mchj-clq-c, Tacoma, WA 98431-1100 | 2017-11-14 |
| 1437679636 | Michael John Zylstra | General Practice | 9040 Jackson Ave Madigan Army Medical Center, Tacoma, WA 98431-5001 | 2017-06-20 |
| 1033666581 | Diana Monzon | Registered Nurse | 9040 Jackson Ave Madigan Army Medical Center, Attn: Mchj-clq-c, Tacoma, WA 98413-1100 | 2016-09-01 |
| 1639541717 | Justin Schafer | Physician Assistant | 9040 Jackson Ave Madigan Army Medical Center, Tacoma, WA 98431-0001 | 2015-10-28 |
| 1164768008 | Kelly Avant | Physical Therapist | 9040 Jackson Ave Madigan Army Medical Center, Tacoma, WA 98431-0001 | 2012-12-21 |
| 1013270180 | Nichole Lynn Mogharreban | Psychologist | 9040 Jackson Ave Madigan Army Medical Center, Tacoma, WA 98431-0001 | 2012-06-22 |
| 1992066765 | Matthew Steven Reece | Anesthesiology | 9040 Jackson Ave Madigan Army Medical Center, Tacoma, WA 98431-5001 | 2012-06-07 |
| 1477824068 | Cynthia Benton Lee | Nurse Anesthetist, Certified Registered | 9040 Jackson Ave Madigan Army Medical Center, Tacoma, WA 98431-2010 | 2012-01-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497212260 | Catrina Renee Grugin | Registered Nurse | Madigan Army Medical Center, Attn Mchj-clq-c, 9040 Jackson Ave, Tacoma, WA 98431 | 2019-02-27 |
| 1801307681 | Bianca Gomez | Dental Assistant | Bldg 9900 Lincoln Street, Jblm, WA 98431 | 2017-10-19 |
| 1184133225 | Darren Paris | Registered Nurse | Madigan Army Medical Center 9040 Jackson Ave., Attn: Mchj-clq-c, Tacoma, WA 98431 | 2017-09-20 |
| 1922538206 | Sarah Frerichs | Dentist | Madigan Annex, Second Floor, Bldg. 9900, Apo, AA 98431 | 2017-06-19 |
| 1740736495 | Misty Hill | Dental Assistant | 9119 Mill Park Ave, Tacoma, WA 98431 | 2016-08-31 |
| 1336695535 | Jacqueline D Massouda | Dentist | Jblm Dentac, 9900 Lincoln Sreet, 2nd Floor, Apo, AA 98431 | 2016-08-28 |
| 1609239375 | Gregg V Palmer | Licensed Practical Nurse | 17th and C Street, Bldg 11582, Tacoma, WA 98431 | 2016-03-31 |
| 1114323904 | Deanna Sheets | Nurse Practitioner | 911 Mil Park Ave, Tacoma, WA 98431 | 2014-11-06 |
| 1679905434 | Austin William Schaar | Dentist | Building 9900, 2nd Floor, Tacoma, WA 98431 | 2013-08-05 |
| 1518209758 | Maurice Ibrahim Khayat | Internal Medicine | 9040 Jackson Ave Mche-qd (creds), Tacoma, WA 98431 | 2013-03-26 |
| Find all providers in zip 98431 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760646129 | Aaron Pace | Dermatology | 1901 S Union Ave Ste B3003, Tacoma, WA 98405-1803 | 2008-07-15 |
| 1508048182 | Angela L Ladenburg | Dermatology | 4707 S 19th St Ste 130, Tacoma, WA 98405-1151 | 2007-12-05 |
| 1699194175 | Thomas Lam | Dermatology | 9040 Jackson Ave, Tacoma, WA 98431-1100 | 2014-04-10 |
| 1225473416 | Vijay Vanchinathan | Dermatology | 209 Martin Luther King Jr Way, Tacoma, WA 98405 | 2013-05-02 |
| 1922398585 | Pace Dermatology Associates, Pllc | Dermatology | 1901 S Union Ave, Suite B 3003, Tacoma, WA 98405-1702 | 2011-04-15 |
| 1881929560 | Andrew Patrick Pace | Dermatology | 1901 S Union Ave, Sute B3003, Tacoma, WA 98405-1702 | 2009-10-13 |
| 1881844116 | Kent Saunders | Dermatology | 9040 Jackson Ave, Tacoma, WA 98431-5648 | 2008-09-23 |
| 1790932903 | Sidney F Whaley Jr | Dermatology | 1708 E 44th St, Community Health Care, Tacoma, WA 98404-4611 | 2008-08-20 |
| 1457418410 | Jill R. Rosenthal | Dermatology | 209 Martin Luther King Jr Way, Tacoma, WA 98405-4265 | 2007-01-02 |
| 1528060902 | James M Komorous Md Ps | Dermatology | 1901 S Union Ave, Ste B-2003, Tacoma, WA 98405-1702 | 2005-08-15 |
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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.