KEVAN MICHAEL PETTERSON
Nurse Practitioner (Family)

Address: 901 Boren Ave Ste 1900, Seattle, WA 98104-3508

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).

Provider Overview

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

Taxonomy

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

Provider Secondary Practice Locations

Address Telephone Number Fax Number
2353 Yale Ave E Unit A, Seattle, WA 981023309 2066797167

Office Location

Street Address 901 BOREN AVE STE 1900
City SEATTLE
State WA
Zip Code 98104-3508

Providers in the same zip code

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

Providers in the same zip code prefix

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
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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to comeā€¦

Providers in the same taxonomy and city

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
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Competitor

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City SEATTLE
Zip Code 98104

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Dataset Information

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.