Kris Allen Peterson, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

MD00031307 Issued in WA

Practice address

9115 Bridgeport Way SW Ste 2
Lakewood, WA 98499-2449

Phone

(253) 393-9099

Fax

(253) 393-9098

NPI assigned

Oct 25, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Uniformed Services Uhs Fe Hebert School of Med, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Puyallup Tribal Health AuthorityGroup PAC ID 9436047537, 35 clinicians

Touchstone TMS PLLCGroup PAC ID 1658701370, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kris.peterson.p1@direct.puyalluptribalhealth.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Touchstone TMS PLLC

  • Psychiatry Physician
  • Lakewood, WA
  • NPI 1669028080
  Medicare reassignment Care Compare group NPD Authorized official
• Puyallup Tribal Health Authority

  • Primary Care Clinic/Center
  • Tacoma, WA
  • NPI 1063455665
  Medicare reassignment Care Compare group
• Hanger Prosthetics & Orthotics West Inc.

  dba Hanger Clinic

  • Prosthetic/Orthotic Supplier
  • Wailuku, HI
  • NPI 1801695234
  NPD (past)

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664841600000",
    "number": "1932284460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9115 BRIDGEPORT WAY SW STE 2",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984992449",
            "telephone_number": "253-393-9099",
            "fax_number": "253-393-9098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9115 BRIDGEPORT WAY SW STE 2",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984992449",
            "telephone_number": "253-393-9099",
            "fax_number": "253-393-9098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "KRIS",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "MD00031307",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "WA",
            "license": "MD00031307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lea Marie Peters, LSWAIC
• Malori Victoria Peters
• Trista Jean Petersen, L.M.P.
• Alexandrea Peterson, LMP
• Julie Peterson, DC
• Kristin Leigh Peterson
• Richard Peterson
• Yoldie Joly Petit DO
• Erica Petru
• Danielle K Pettaway

• Child & Adolescent Psychiatry Physician in Lakewood, WA
• Providers in Lakewood, WA by specialty
• Child & Adolescent Psychiatry Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.