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1396934238
JOHANNA RAE PETERSON
BEND, OR
NPI
1396934238
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Former Name
JOHANNA RAE GODELL
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: OR PA01280)
Enumeration Date
2007-10-16
Last Update Date
2024-09-17
Business Address
Mrs. JOHANNA RAE PETERSON PA-C
2200 NE NEFF RD STE 302
BEND, OR 97701-4279
Phone number: 541-706-4220
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Mailing Address
Mrs. JOHANNA RAE PETERSON PA-C
PO BOX 1188
CORVALLIS, OR 97339-1188
Phone number:
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