Individual provider · Type 1 NPI

Michael Jake Petersen, MD

Pediatric Sports Medicine Physician · Seattle, WA

NPI number 1780248146 Active

Practice location

3800 Montlake Blvd
Seattle, WA 98195-0007

Call (206) 520-5000 Map

Mailing address

2516 Stockton Blvd
Sacramento, CA 95817-2208

Specialties and licenses

TaxonomyCodeLicense
Pediatric Sports Medicine Physician Primary 2080S0010XMD.MD.61679347 (WA)

Pediatric Sports Medicine Physician: A pediatrician who is responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology,…

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About NPI 1780248146

Michael Jake Petersen, MD's National Provider Identifier is 1780248146, issued on Apr 30, 2019. The primary taxonomy on file is Pediatric Sports Medicine Physician (2080S0010X), and the practice location is in Seattle, WA. The record was last updated on Apr 11, 2026.