Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1659868560 Individual Practitioner Female Practitioner

Dr. Iris Havlina Donovan Petersen , MD

Pediatrics • Olympia, WA

Professional Overview & Biography Verified Profile Summary

Dr. Iris Petersen, MD is a registered healthcare professional specializing in Pediatrics in Olympia, WA. Practice services are available at 3434 12TH AVE NE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

3434 12th Ave Ne

Olympia, WA 985065175

Telephone 3604138470
Associated Practice Facility / Clinic
🏢 Olympia Pediatrics, Pllc Facility NPI 1306012083

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Olympia, WA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 18.8 Yrs
Regional Practice Density
35 Specialists

Practicing in Olympia, WA (1802 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2021-08-08
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License WA MD61140296

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Pediatrics

NUCC Taxonomy Code: 208000000X

State License UT 11405455-1205

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

16 Associated Practitioners
NPI 1003883679

Doctor of Medicine (M.D.)

NPI 1063534808

Doctor of Medicine (M.D.)

Katherine Berndt , ARNP

Nurse Practitioner - Pediatrics

NPI 1083700199

Advanced Registered Nurse Practitioner

NPI 1215466347

DNPPNP

NPI 1225369770

Doctor of Medicine (M.D.)

Nila Williamson , MPH, RD, CD, IBCLC

Dietitian, Registered - Nutrition, Pediatric

NPI 1265752018

Master of Public Health, Registered Dietitian, CD, International Board Certified Lactation Consultant

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

12 Historical Events
📍
Updated Practice Location August 08, 2021

Registered at 3434 12TH AVE NE, OLYMPIA, WA 985065175 (Tel: 3604138470)

📍
Updated Business Mailing Address August 08, 2021

Registered at 3434 12TH AVE NE, OLYMPIA, WA 985065175 (Tel: 3604138470)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 08, 2021

Pediatrics (License #MD61140296 in WA)

📍
Updated Practice Location September 16, 2019

Registered at 81 N MARIO CAPECCHI DR, SALT LAKE CITY, UT 841131125 (Tel: 8016621000)

📍
Updated Business Mailing Address September 16, 2019

Registered at 81 N MARIO CAPECCHI DR, SALT LAKE CITY, UT 841131125

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 16, 2019

Pediatrics (License #11405455-1205 in UT)

NPI Profile Active April 16, 2018

NPI status registered as active in NPPES database

📍
Updated Practice Location April 16, 2018

Registered at 100 N MARIO CAPECCHI DR, SALT LAKE CITY, UT 841131103 (Tel: 8016621000)

📍
Updated Business Mailing Address April 16, 2018

Registered at 1931 LAKEHURST DR SE, OLYMPIA, WA 985014270

👤
Provider Name / Credentials Updated April 16, 2018

Recorded as IRIS PETERSEN, MD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 16, 2018

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration April 16, 2018

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1659868560
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 16, 2018
Last Update: August 08, 2021
Sole Proprietor: No

Mailing Address

3434 12th Ave Ne

Olympia, WA 985065175

Phone: 3604138470

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.