Provider Demographics
NPI:1194601344
Name:PEIFER, JONATHAN (LPN)
Entity type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:
Last Name:PEIFER
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3501 MILL PL S
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-5890
Mailing Address - Country:US
Mailing Address - Phone:206-769-1189
Mailing Address - Fax:
Practice Address - Street 1:200 15TH AVE E
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-5260
Practice Address - Country:US
Practice Address - Phone:253-549-9668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-13
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALP00053037164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse