PETERSEN INVESTMENTS, LLC (NPI# 1518504984) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518504984 |
| Entity Type | Organization |
| Organization Name | PETERSEN INVESTMENTS, LLC |
| Other Organization Name | COLUMBIA COMPOUNDING |
| Practice Address |
12119 Ne 99th St Ste 2030 Vancouver WA 98682-2461 |
| Practice Telephone | 3602174250 |
| Practice Fax Number | 3602301919 |
| Mailing Telephone | 3602174250 |
| Mailing Fax Number | 3602301919 |
| Enumeration Date | 2019-12-04 |
| Last Update Date | 2020-02-21 |
| Authorized Official Name | KRISTOPHER PETERSEN (MANAGING MEMBER) |
| Authorized Official Telephone | 3602619040 |
| Authorized Official Credential | PHARMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
Suppliers |
| Other Name | Type Code |
|---|---|
| Columbia Compounding | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | PETERSEN INVESTMENTS, LLC | 12119 Ne 99th St, #2030, Vancouver, WA 98682-2461 |
| Street Address |
12119 NE 99TH ST STE 2030 |
| City | VANCOUVER |
| State | WA |
| Zip Code | 98682-2461 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184230625 | Helen Trinidad Uy | Registered Nurse | 15814 Ne 72nd St., Vancouver, WA 98682 | 2020-09-21 |
| 1891258711 | Washington Dental Corporation, PC | Dentist | 14411 Ne Fourth Plain, Suite 134, Vancouver, WA 98682 | 2019-04-08 |
| 1588174833 | Oliver Uy | Nurse Practitioner | 15814 Ne 72nd, Vancouver, WA 98682 | 2017-10-01 |
| 1285095000 | Julia Melinda Zamora | Naturopath | 15640 Ne Fourth Plain Blvd Ste 120a, Vancouver, WA 98682 | 2016-03-08 |
| 1871999243 | Jumana Sayyam | Counselor | 13114 Ne 41st St, Vancouver, WA 98682 | 2014-11-13 |
| 1679998538 | Chris Briggs | Massage Therapist | 6700 N.e. 162 Ave, Suite 415, Vancouver, WA 98682 | 2014-02-28 |
| 1790113371 | Kaiser Foundation Health Plan of The Northwest | Pharmacy | 1230 7th Ave., Longview, WA 98682 | 2013-10-17 |
| 1821336736 | Carol Lynn Fischer | Occupational Therapist | 13501 Ne 28th Street, Vancouver, WA 98682 | 2013-01-28 |
| 1336412485 | Erica Paige Schmidt | Massage Therapist | 13025 Ne 4th Plain Blvd, Suite 102, Vancouver, WA 98682 | 2012-02-21 |
| 1669767828 | Scott Germann | Contractor | 15410 Ne 85th Street, Vancouver, WA 98682 | 2011-06-16 |
| Find all providers in zip 98682 | ||||
| Taxonomy Code | 3336C0004X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Compounding Pharmacy |
| A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner’s Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice. |
| Notes: Sources: NABP Model Practice Act, Appendix C - Good Compounding Practice, USP <795> and <797>, and Pharmacy Compounding Accreditation Board [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417581943 | Jike LLC | Pharmacy | 8614 E Mill Plain Blvd Ste 110, Vancouver, WA 98664-2058 | 2020-02-24 |
| 1518444025 | Columbia Pharmacy | Pharmacy | 2700 Ne Andresen Rd Ste E3, Vancouver, WA 98661 | 2018-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730500067 | Kelley-ross and Assoc, Inc. | Pharmacy | 805 Madison St # 702, Seattle, WA 98104-1172 | 2014-01-06 |
| 1962779348 | Poulsbo Compounding Pharmacy LLC | Pharmacy | 325 Ne Hostmark Street, Poulsbo, WA 98370 | 2011-11-29 |
| 1114237633 | Poulsbo Compounding Pharmacy LLC | Pharmacy | 325 Ne Hostmark St, Poulsbo, WA 98370-6668 | 2010-10-18 |
| 1750601472 | Sound Apothecaries | Pharmacy | 1851 State Ave Ne Ste 105, Olympia, WA 98506-4601 | 2010-06-03 |
| 1699094417 | Darvic Assoc. Inc. | Pharmacy | 1907 Harrison Ave Nw, Olympia, WA 98502-5118 | 2010-05-18 |
| 1093961146 | Mipa Corp | Pharmacy | 4629 168th St Sw Ste A, Lynnwood, WA 98037-8640 | 2008-08-08 |
| 1578760260 | Pharmaca Integrative Pharmacy, Inc. | Pharmacy | 1815 N. 45th Street, Suite 110, Seattle, WA 98103 | 2007-06-27 |
| 1528199619 | Don's Pharmacy Inc. | Pharmacy | 1151 Water St, Port Townsend, WA 98368-6707 | 2007-03-08 |
| 1538216619 | Schwab's Compounding Pharmacy, Inc | Pharmacy | 108 B Railroad Ave., Kittitas, WA 98934 | 2007-01-04 |
| 1629137096 | Kelley-ross & Assoc Inc | Pharmacy | 910 Lenora St, Ste 152, Seattle, WA 98121-2754 | 2006-12-08 |
| Find all providers with the same taxonomy | ||||
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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.