L Dana Petersen, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD00014912 Issued in WA

Practice address

11155 Railroad Creek Valley Rd
Holden Village Medic
Chelan, WA 98816

Phone

(360) 319-9829

NPI assigned

Jun 9, 2006

Last updated

May 31, 2016By the provider in NPPES

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)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464652800000",
    "number": "1649211731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2",
            "address_2": "HOLDEN VILLAGE MEDIC",
            "city": "CHELAN",
            "state": "WA",
            "postal_code": "988160002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11155 RAILROAD CREEK VALLEY RD",
            "address_2": "HOLDEN VILLAGE MEDIC",
            "city": "CHELAN",
            "state": "WA",
            "postal_code": "98816",
            "telephone_number": "360-319-9829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "L",
        "middle_name": "DANA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2016-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00014912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Refugio Ortega, LMT
• Frances K Oswald, L.M.P.
• Virginia W Palumbo, RN
• Patricia Joy Papadopoulos, MD
• Beverly Ann Peters, LMP
• Erin Skye Phelps, LMHC
• Elspeth Fullerton Piper, MD
• Magnolia May Polley, LMP
• Brittney Potter
• Edward John Rauvola Jr., RPH

• Family Medicine Physician in Chelan, WA
• Providers in Chelan, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2016; 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.