Joshua M Petersen, M.ED, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

60863058 Issued in WA

Practice address

342 SW 16TH St
Chehalis, WA 98532-3809

Phone

(360) 807-7235

NPI assigned

Feb 20, 2018

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1519084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623024000000",
    "number": "1245730985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 FENWAY DR",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985327904",
            "telephone_number": "206-353-8850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "342 SW 16TH ST",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985323809",
            "telephone_number": "360-807-7235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "JOSHUA",
        "middle_name": "M",
        "credential": "M.ED, LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-20",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WA",
            "license": "60863058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah J Perry, LMT
• Personal Hearing Systems, Inc
• Peter C. Wagner, D.M.D., P.S.
• Jason R Peterman, R.N.
• Dale Raymond Peters, DC
• John Pham, D.D.S.
• Norma Jane Phillips, LMT
• Virginia M Pickett, HS
• Zachary Allen Pilz, A.A.
• Amir M Piranfar, PHARM.D.

• Athletic Trainer in Chehalis, WA
• Providers in Chehalis, WA by specialty
• Athletic Trainer in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.