DALE J PETERSON (NPI# 1912956376) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912956376 |
| Entity Type | Individual |
| Full Name | DALE J PETERSON |
| Credential | MD |
| Practice Address |
1025 S 2nd Ave Walla Walla WA 99362-4116 |
| Mailing Address |
218 Ne A St College Place WA 99324-1114 |
| Practice Telephone | 5095250480 |
| Practice Fax Number | 5095278195 |
| Mailing Telephone | 5095290258 |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2017-03-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | MD00040686 | WA | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | MD00040686 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 1093161 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023234572 | Dale L Peterson | Psychologist | Metro Maryland Counseling Center, 16 Greenmeadow Drive, Suite G106, Timonium, MD 21093 | 2007-04-17 |
| 1164552048 | Dale Robert Peterson | Dentist | 555 S 5th St, Lander, WY 82520-3245 | 2007-03-07 |
| 1265543573 | Dale Reed Peterson | Dentist | 160 Wapato Way, Manson, WA 98831 | 2006-08-31 |
| 1093815672 | Dale M. Peterson | Psychiatry & Neurology | 2825 8th Ave N, Billings, MT 59101-0909 | 2006-09-24 |
| 1407872476 | Dale T Peterson | Urology | 820 N Chelan Ave, Wenatchee, WA 98801-2028 | 2006-07-14 |
| Street Address |
1025 S 2ND AVE |
| City | WALLA WALLA |
| State | WA |
| Zip Code | 99362-4116 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063413334 | Barry Michael Mallard | Pharmacist | 1025 S 2nd Ave, Walla Walla, WA 99362-4116 | 2005-08-09 |
| 1053911180 | Alisha Andersen | Occupational Therapist | 1025 S 2nd Ave, Walla Walla, WA 99362-4116 | 2020-10-28 |
| 1306492293 | Morgan Anne Ratchford | Massage Therapist | 1025 S 2nd Ave, Walla Walla, WA 99362-4116 | 2019-08-15 |
| 1316433527 | Providence Health & Services - Washington | Clinical Medical Laboratory | 1025 S 2nd Ave, Walla Walla, WA 99362-4116 | 2018-07-11 |
| 1760921423 | Trinity Medical PC | Family Medicine | 1025 S 2nd Ave, Walla Walla, WA 99362-4116 | 2017-02-14 |
| 1124578133 | Michelle Dawn Grove | Dietitian, Registered | 1025 S 2nd Ave, Walla Walla, WA 99362-4116 | 2016-10-13 |
| 1053787747 | Im Locum LLC | Internal Medicine | 1025 S 2nd Ave, Walla Walla, WA 99362-4116 | 2015-08-17 |
| 1578812418 | Leslie Ann Esparza | Pharmacist | 1025 S 2nd Ave, Walla Walla, WA 99362-4116 | 2012-09-06 |
| 1669728648 | Melissa Todhunter Murphy | Speech-Language Pathologist | 1025 S 2nd Ave, Walla Walla, WA 99362-4116 | 2012-07-27 |
| 1598039331 | Alan Mcfadden PC | Anesthesiology | 1025 S 2nd Ave, Walla Walla, WA 99362-4116 | 2012-02-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164065959 | Kevin Gia-minh Phan | Optometrist | Walla Walla Vamc Bldg 86, Walla Walla, WA 99362 | 2019-10-24 |
| 1659836401 | Arlene Lavonne Whitney | Social Worker | 1361 Dalles Military Road, Walla Walla, WA 99362 | 2019-02-06 |
| 1053880674 | Julie Ann Cooke | Speech-Language Pathologist | Providence St. Mary Medical Center, 401 W. Poplar St., Walla Walla, WA 99362 | 2018-11-14 |
| 1558887133 | Chantey Walker | Massage Therapist | 1840 Pleasant St, Walla Walla, WA 99362 | 2017-08-16 |
| 1447798723 | Carrie S Diede | Speech-Language Pathologist | 410 West Poplar Street, Rehabilitation Services, Walla Walla, WA 99362 | 2017-02-07 |
| 1235584103 | Anchor Point Counseling Pllc | Clinic/Center | 2330 Eastgate St. Ste. 140, Walla Walla, WA 99362 | 2016-04-28 |
| 1548627011 | Washington State Walla Walla Veterans Home | Skilled Nursing Facility | 92 Wainwright Drive, Walla Walla, WA 99362 | 2016-01-28 |
| 1073926200 | Sherry Goff | Registered Nurse | 11120 W Rose St, Family Medical Center, Walla Walla, WA 99362 | 2014-06-05 |
| 1538597935 | Michael Wade Gillespie | Orthopaedic Surgery | 101 Brookside Drive, Walla Walla, WA 99362 | 2013-10-22 |
| 1023357985 | Sandra Kay Bushnell | Speech-Language Pathologist | 1105 Isaacs Ave, Walla Walla, WA 99362 | 2013-02-12 |
| Find all providers in zip 99362 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235243155 | Joilo Barbosa | Emergency Medicine | 123 E Main St # 268, Walla Walla, WA 99362-1923 | 2006-08-18 |
| 1225052996 | Shirley Robin Vonhaven | Emergency Medicine | 401 W Poplar, Walla Walla, WA 99362 | 2006-07-27 |
| 1538351606 | Edward Alan Lisenbey | Emergency Medicine | 401 W Poplar St, Psmmc Er, Walla Walla, WA 99362-2846 | 2007-08-13 |
| 1225238207 | Jared L Wutzke | Emergency Medicine | 401 W Poplar St, Psmmc Er, Walla Walla, WA 99362-2846 | 2007-07-19 |
| 1336340603 | Eric Trent Brown | Emergency Medicine | 401 W Poplar St, Psmmc Er, Walla Walla, WA 99362-2846 | 2007-05-31 |
| 1073698437 | St Mary Medical Center | Emergency Medicine | 401 W Poplar, Walla Walla, WA 99362 | 2006-10-26 |
| 1407960339 | Renee M Schroetlin | Emergency Medicine | 401 W Poplar St, Emergency Department, Walla Walla, WA 99362-2846 | 2006-08-18 |
| 1932115169 | James J Edwards | Emergency Medicine | 380 Chase Ave, Convenient Care, Walla Walla, WA 99362-2924 | 2006-07-31 |
| 1588678999 | Daniel Byron Miller | Emergency Medicine | 401 W Poplar St, Psmmc Er, Walla Walla, WA 99362-2846 | 2006-07-28 |
| 1487668893 | Robert A Billingsley | Emergency Medicine | 401 W Poplar St, Psmmc Er, Walla Walla, WA 99362-2846 | 2006-07-28 |
| Find all providers in WALLA WALLA | ||||
| City | WALLA WALLA |
| Zip Code | 99362 |
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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.