Provider Demographics
NPI:1518595602
Name:ORSBON, COURTNEY PETERSON (MD, PHD)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:PETERSON
Last Name:ORSBON
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:EVA
Other - Last Name:PETERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:111 COLCHESTER AVENUE
Mailing Address - Street 2:SHEPARDSON 564
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401
Mailing Address - Country:US
Mailing Address - Phone:802-847-5162
Mailing Address - Fax:802-847-0420
Practice Address - Street 1:1959 NE PACIFIC ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-0001
Practice Address - Country:US
Practice Address - Phone:704-641-7863
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-01
Last Update Date:2021-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program