| Mr Lynn A Peterson, MSN, CRNA | |
|
714 W Pine St, Newport, WA 99156-9046 | |
| (509) 447-2441 | |
| (509) 447-2281 |
| Full Name | Mr Lynn A Peterson |
|---|---|
| Gender | Male |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 714 W Pine St, Newport, Washington |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720165160 | NPI | - | NPPES |
| G000381050 | Other | WA | MEDICARE GROUP NUMBER |
| P00395894 | Other | WA | MEDICARE RAILROAD |
| CG4026 | Other | WA | RAILROAD GROUP NUMBER |
| 9636465 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | AP30006221 (Washington) | Primary |
| Entity Name | Pend Oreille County Public Hospital District No 1 |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1427264795 PECOS PAC ID: 3274431184 Enrollment ID: O20031230000017 |
| Entity Name | Pend Oreille County Public Hospital District No 1 |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1780778423 PECOS PAC ID: 3274431184 Enrollment ID: O20061104000539 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Lynn A Peterson, MSN, CRNA 3412 S Jefferson Dr, Spokane, WA 99203-1421 Ph: (509) 220-3834 | Mr Lynn A Peterson, MSN, CRNA 714 W Pine St, Newport, WA 99156-9046 Ph: (509) 447-2441 |
Andrew P Hansen, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 714 W Pine St, Newport, WA 99156 Phone: 509-447-2441 | |
Alicia Danielle Schultz, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 714 W Pine St, Newport, WA 99156 Phone: 509-447-2441 |