Kenneth Petersen, RPH

NPI 1972879401 · on the registry since 2012

Practice

Address: 5500 Martin Way E
Lacey, WA 98516
Phone: (360) 456-4057
Organisation at this address: Shopko Stores Operating Co Llc
Shopko Stores Operating Co. Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 3

Registry record

Primary taxonomy: Pharmacist
183500000X
Licence states on file: WA
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2012-03-29

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 Washington