Henry Petersen, PA-C

NPI 1891123543 · on the registry since 2013

Practice

Address: 700 W Ironwood Dr
Ste 320
Coeur D Alene, ID 83814
Phone: (208) 625-5250
Fax: (208) 625-5251
Organisation at this address: Element Dental Pllc
Ideal Family Dental
Kootenai Health, Inc.
Kootenai Health, Inc.
Interlake Pharmacy Inc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 191

Registry record

Primary taxonomy: 363AM0700X
363AM0700X
Licence states on file: ID
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2025-07-22

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho