Provider Demographics
NPI:1992756498
Name:BESSAS, PETER JAMES (MD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:JAMES
Last Name:BESSAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:13115 NE 4TH ST
Mailing Address - Street 2:SUITE 230
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684-5957
Mailing Address - Country:US
Mailing Address - Phone:360-828-8008
Mailing Address - Fax:360-326-1609
Practice Address - Street 1:13115 NE 4TH ST
Practice Address - Street 2:SUITE 230
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-5957
Practice Address - Country:US
Practice Address - Phone:360-828-8008
Practice Address - Fax:360-326-1609
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2014-07-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD41827207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB 35124Medicare ID - Type Unspecified
WAH 78461Medicare UPIN