Peter Forber Vanderven PLLC

Primary specialty

DentistTaxonomy code 122300000X

License

602515196 Issued in WA

Legal business name

PETER FORBER VANDERVEN PLLC

Doing business as

South Sound Oral Medicine

Practice address

34709 9TH Ave S
Suite B-300
Federal Way, WA 98003-8722

Phone

(253) 874-2583

Fax

(253) 874-8957

NPI assigned

May 18, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Sandra Louise Harrelson

Title

Financial Coordinator

Phone

(253) 874-2583

Specialties & licenses 1

Addresses

Other names 1

• South Sound Oral Medicine Doing business as

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364169600000",
    "number": "1831142827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34709 9TH AVE S",
            "address_2": "SUITE B-300",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980038722",
            "telephone_number": "253-874-2583",
            "fax_number": "253-874-8957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34709 9TH AVE S",
            "address_2": "SUITE B-300",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980038722",
            "telephone_number": "253-874-2583",
            "fax_number": "253-874-8957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETER FORBER VANDERVEN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2013-03-25",
        "status": "A",
        "authorized_official_last_name": "HARRELSON",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "FINANCIAL COORDINATOR",
        "authorized_official_telephone_number": "253-874-2583",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "WA",
            "license": "602515196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Sound Oral Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stacey L Perry, DPM
• Karin Persson-Medina, LMP
• Asad Pervez, MD
• Thomas C Petek, PHD
• Peter B Shelley MD PS (Federal Way Eye & Laser Center)
• Jo Ann Peter, PT
• Sarah J Peters, LMP
• Marc G Petersen, LMP
• Amber N Peterson, PSYD, LP
• Michele Jennefer Peterson, L.M.P.

• Dentist in Federal Way, WA
• Providers in Federal Way, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2013; 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.