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1356615470
KEITH E PETERSEN
TACOMA, WA
NPI
1356615470
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207QA0505X Family Medicine, Adult Medicine
(Licence: WA 60595760)
Enumeration Date
2012-03-07
Last Update Date
2024-03-12
Business Address
KEITH E PETERSEN DO
9040 JACKSON AVE
TACOMA, WA 98431-1000
Phone number: 253-968-1340
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Mailing Address
KEITH E PETERSEN DO
9040 JACKSON AVE 9040 JACKSON STREET
TACOMA, WA 98431-1000
Phone number: 253-968-1340
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