| Christopher Glen Petersen, OD | |
|
701 2nd Ave Se, Quincy, WA 98848-1531 | |
| (509) 787-1581 | |
| (509) 787-9176 |
| Full Name | Christopher Glen Petersen |
|---|---|
| Gender | Male |
| Speciality | Optometrist |
| Location | 701 2nd Ave Se, Quincy, Washington |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316937840 | NPI | - | NPPES |
| 2021194 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | OD1175TX (Washington) | Primary |
| 152W00000X | Optometrist | 0573 (Idaho) | Secondary |
| Mailing Address | Practice Location Address |
|---|---|
| Christopher Glen Petersen, OD Po Box 488, Quincy, WA 98848-0488 Ph: (509) 787-1581 | Christopher Glen Petersen, OD 701 2nd Ave Se, Quincy, WA 98848-1531 Ph: (509) 787-1581 |
Kyle Morgan Gillespie, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 701 2nd Ave Se, Quincy, WA 98848 Phone: 509-787-1581 | |
Gillespie Eye Care Optometrist Medicare: Medicare Enrolled Practice Location: 701 2nd Ave Se, Quincy, WA 98848 Phone: 509-787-1581 Fax: 509-787-9176 |