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Mrs. Kay Diane Peterson, PMHNP
Community Health Nurse Practitioner in Portland, Oregon
NPI 1457367690

Kay Diane Peterson is a Community Health Nurse Practitioner based in Portland, OR and is specialized in Community Health. Kay Diane Peterson practices in Portland, OR and has the professional credentials of PMHNP. The NPI Number for Kay Diane Peterson is 1457367690 and holds a License No. 093006731N6 (Oregon).

The current practice location address for Kay Diane Peterson is 412 Sw 12Th Ave, Portland, OR and can be reached out via phone at 503-228-7134 and via fax at 503-944-2595. You can also correspond with Kay Diane Peterson through the mailing address at 7056 SE PINE ST, PORTLAND, OR - 97215-1430 (mailing address contact number: 503-255-6768).

Location: 412 Sw 12Th Ave, Portland, OR, 97215-1430
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Provider Profile Details
NPI Number
1457367690
Provider Name
Kay Diane Peterson
Credential
PMHNP
Provider Entity Type
Individual
Gender
Female
Address
412 Sw 12Th Ave, Portland, OR, 97215-1430
Phone Number
503-228-7134
Fax Number
503-944-2595
Provider Enumeration Date
07/31/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
069596 05 OR
institution
Provider Business Practice Location Address Details
Address
412 Sw 12Th Ave
City
State
Zip
97205-2329
Phone Number
503-228-7134
Fax Number
503-944-2595
person
Provider Business Mailing Address Details
Address
412 Sw 12Th Ave
City
State
Zip
97205-2329
Phone Number
503-228-7134
Fax Number
503-944-2595
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Community Health
Taxonomy
License No.
093006731N6 (Oregon)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Psychiatric/Mental Health
Taxonomy
License No.
093006731N6 (Oregon)
Definition
Definition to come...
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