Active NPI
Pamela Peterson, RN
- Medical-Surgical Registered Nurse
- Richland, WA
National Provider Identifier
1972516532
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical-Surgical Registered Nurse
- License
- RN00047360
- Practice address
- 945 Goethals Dr
Suite 200
Richland, WA 99352-3552 - Phone
- (509) 943-0300
- Fax
- (509) 946-0707
- NPI assigned
- Aug 14, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical-Surgical Registered Nurse | 163WM0705X | RN00047360 | WA | Primary |
Addresses
Primary practice location
945 Goethals Dr
Suite 200
Richland, WA 99352-3552
Mailing address
945 Goethals Dr
Suite 200
Richland, WA 99352-3552
Phone (509) 943-0300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9627845 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN00047360 | WA | MD | Medical-Surgical Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1972516532",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "945 GOETHALS DR",
"address_2": "SUITE 200",
"city": "RICHLAND",
"state": "WA",
"postal_code": "993523552",
"telephone_number": "509-943-0300",
"fax_number": "509-946-0707"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "945 GOETHALS DR",
"address_2": "SUITE 200",
"city": "RICHLAND",
"state": "WA",
"postal_code": "993523552",
"telephone_number": "509-943-0300",
"fax_number": "509-946-0707"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "PAMELA",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "163WM0705X",
"taxonomy_group": "",
"desc": "Registered Nurse, Medical-Surgical",
"state": "WA",
"license": "RN00047360",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9627845",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Richland, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.