KEVAN MICHAEL PETTERSON (NPI# 1942894670) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942894670 |
| Entity Type | Individual |
| Full Name | DR. KEVAN MICHAEL PETTERSON |
| Gender | Male |
| Credential | DNP, FNP |
| Practice Address | 901 Boren Ave Ste 1900 Seattle WA 98104-3508 |
| Practice Telephone | 2066226444 |
| Mailing Address | 2353 Yale Ave E Unit A Seattle WA 98102-3309 |
| Mailing Telephone | 2066797167 |
| Certification Date | 2021-02-23 |
| Enumeration Date | 2021-02-23 |
| Last Update Date | 2021-02-23 |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | Group | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|---|
| Y | 363LF0000X | Nurse Practitioner Specialization: Family | 61145175 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2353 Yale Ave E Unit A, Seattle, WA 981023309 | 2066797167 |
| Street Address | 901 BOREN AVE STE 1900 |
| City | SEATTLE |
| State | WA |
| Zip Code | 98104-3508 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164049755 | Daniela Rita Baumgarthuber | Social Worker · Clinical | 901 Boren Ave Ste 1020, Seattle, WA 98104-3508 | 2020-06-29 |
| 1104443183 | Keisha Harris | Social Worker · Clinical | 901 Boren Ave Ste 1020, Seattle, WA 98104-3508 | 2020-06-25 |
| 1942776901 | Rachel Sharon Weinbaum Seidman | Pharmacy · Community/Retail Pharmacy | 901 Boren Ave Ste 100, Seattle, WA 98104-3508 | 2018-10-17 |
| 1164898714 | Hannah Jane Sanders | Marriage & Family Therapist | 901 Boren Ave Ste 1020, Seattle, WA 98104-3508 | 2015-08-18 |
| 1184044109 | Ansebe Bicoff- Smit · Ansebe Smit | Counselor · Mental Health | 901 Boren Ave Ste 701, Seattle, WA 98104-3508 | 2014-04-17 |
| 1689869703 | Christy Marie Moore | Physician Assistant · Surgical | 901 Boren Ave Ste 1650, Seattle, WA 98104-3508 | 2007-09-11 |
| 1487713699 | Laurie Anne Brenner | Registered Nurse · Medical-Surgical | 901 Boren Ave Ste 1650, Seattle, WA 98104-3508 | 2006-12-06 |
| 1801961750 | Rahul Khurana | Psychiatry & Neurology · Psychiatry | 901 Boren Ave, Suite 701, Seattle, WA 98104-3508 | 2006-11-22 |
| 1427122100 | Stephen J Melson · Stephen J Melson | Psychologist | 901 Boren Ave, Suite 1020, Seattle, WA 98104-3508 | 2006-11-17 |
| 1033207642 | Mary Lee Peters | Specialist | 901 Boren Ave Ste 1650, Seattle, WA 98104-3508 | 2006-10-10 |
| Find all providers in zip 98104-3508 | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023623840 | Rachael Noce | Registered Nurse · Psychiatric/Mental Health | 401 Broadway, Seattle, WA 98104 | 2020-09-09 |
| 1184246530 | Sakisha Bailey | Counselor | 401 Broadway, Suite 1, Seattle, WA 98104 | 2020-05-08 |
| 1356961197 | Amanda Kay Debock | Registered Nurse | 401 Broadway, Suite 2075, Seattle, WA 98104 | 2020-04-22 |
| 1699394312 | Richard Charles Harruff | Pathology · Forensic Pathology | King County Medical Examiners Office, 325 Ninth Avenue, Seattle, WA 98104 | 2020-04-13 |
| 1558999474 | Nathan Richard Benner | Student in an Organized Health Care Education/Training Program | Uw Medicine-Harborview Medical Center Orthopaedics, 325 Ninth Avenue, Seattle, WA 98104 | 2020-03-27 |
| 1063058493 | Brook, Inc. | Health Educator | 311 1/2 Occidental Ave South, Suite 210, Seattle, WA 98104 | 2019-11-20 |
| 1609418813 | Stephanie Amanda Ann Mason | Student in an Organized Health Care Education/Training Program | 325 9th Avenue, Mail Stop #359796, Seattle, WA 98104 | 2019-10-09 |
| 1740832419 | Qiuye Wang | Massage Therapist | 608 8th Ave S, Seattle, WA 98104 | 2019-07-12 |
| 1114585387 | Suya Tan | Massage Therapist | 608 8th Ave S, Seattle, WA 98104 | 2019-06-03 |
| 1891359543 | Thomas Shea Fitzpatrick | Student in an Organized Health Care Education/Training Program | 206 3rd Ave S, Seattle, WA 98104 | 2019-04-29 |
| Find all providers in zip 98104 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come… |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396330387 | Cheyenne Michaela Hedrick | 531 Queen Anne Ave N, Seattle, WA 98109-4521 | 2021-03-02 | |
| 1720670110 | Bailey Elizabeth Eley · Bailey Elizabeth Claussen | 1420 Terry Ave Unit 604, Seattle, WA 98101-1989 | 2021-02-07 | |
| 1609464676 | Valerie Brand · Valerie Lybyer | 12537 41st Ave Ne, Seattle, WA 98125-4647 | 2021-01-06 | |
| 1649872896 | Esther Iwuoha | 620 Terry Ave Unit 202, Seattle, WA 98104-2020 | 2020-11-12 | |
| 1659970291 | Madaline Marie Yguado Goldmann | 1633 Westlake Ave N Ste 105, Seattle, WA 98109-6241 | 2020-10-24 | |
| 1063025476 | Christopher Charles Borgia | 6020 35th Ave Sw, Seattle, WA 98126-3002 | 2020-08-25 | |
| 1174135891 | Barbara Oldenburger | 4800 Sand Point Way Ne, Seattle, WA 98105-3901 | 2020-08-24 | |
| 1841800521 | Lauren Levesque · Lauren Johnson | 2744 Ne 54th St Unit B, Seattle, WA 98105-3146 | 2020-08-06 | |
| 1588273668 | Diep N Nguyen | 1660 S Columbian Way, Seattle, WA 98108-1532 | 2020-07-24 | |
| 1215546544 | Madelyn D Pimentel | 8720 14th Ave S, Seattle, WA 98108-4807 | 2020-07-22 | |
| Find all providers in SEATTLE | ||||
| City | SEATTLE |
| Zip Code | 98104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952711657 | Kevan Meadors · Kevan Elizabeth Meadors | Student in an Organized Health Care Education/Training Program | 5201 Harry Hines Blvd, Dallas, TX 75235-7708 | 2014-05-02 |
| 1164060547 | Kevan Michael Holland | Registered Nurse | 601 E Rollins St, Orlando, FL 32803-1248 | 2019-12-16 |
| 1457611477 | Mara Kevan Mitchell · Mara S Kevan | Acupuncturist | 701 Nw Arizona Ave Ste 200, Bend, OR 97701-3298 | 2012-05-23 |
| 1720623036 | Kevan Michael Poley | Internal Medicine | 1845 Jaclif Ct, Tallahassee, FL 32308-4430 | 2019-11-11 |
| 1013939495 | Kevan Alexander Mccarten-Gibbs · Kevan Alexander Mccarten | Pediatrics · Pediatric Emergency Medicine | 747 52nd St, Department of Emergency Medicine, Oakland, CA 94609-1809 | 2006-07-24 |
| 1295846376 | Dean B Petterson Dmd PC | Dentist · General Practice | 121 Nw 1st St, Gresham, OR 97030-7215 | 2006-08-31 |
| 1952933244 | Kathryn Ann Petterson | Counselor · Mental Health | 295 S Culver St Ste D, Lawrenceville, GA 30046-3239 | 2020-02-05 |
| 1245787530 | Eric E. Petterson P.C. | Internal Medicine · Addiction Medicine | 1 S Main St, Shenandoah, PA 17976-2332 | 2016-09-05 |
| 1013964980 | Grace C. Petterson | Specialist | 1294 W 6th St, Ste#102, San Pedro, CA 90731-2987 | 2006-05-27 |
| 1568529170 | Kathryn Petterson LLC | Counselor | 295 S Culver St Ste D, Lawrenceville, GA 30046-3239 | 2007-01-02 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.