Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Cornelius R Peterson, MD

Individual provider Anesthesiology Physician · NPI 1063642957

Dr. Cornelius R Peterson, MD is an Anesthesiology in Spokane, Washington. Graduated from University of Kansas School of Med (KC/WICH/SAL) in 2009, 17 years ago. Practices with Providence Health and Service- Washington, a 172-clinician group and accepts Medicare assignment. Licensed in Kansas, Nebraska and Washington.

Years since qualifying
17
Trained at
University of Kansas School of Med (KC/WICH/SAL)
Licensed in
KS, NE, WA
In the registry since
2009
Specialties on file
4
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

101 W 8th Ave
Spokane, WA 99204-2307
Phone: (509) 474-3181
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anesthesiology Physician (primary) Taxonomy 207L00000X · Licence MD61305762 (WA)
Internal Medicine Physician Taxonomy 207R00000X · Licence 9407283 (KS)
Anesthesiology Physician Taxonomy 207L00000X · Licence 9407283 (KS)
Anesthesiology Physician Taxonomy 207L00000X · Licence 27117 (NE)

Record details

NPI number1063642957
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedJuly 25, 2009
Last updated in NPPESAugust 1, 2022
Certification dateAugust 1, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyANESTHESIOLOGY
Medical schoolUNIVERSITY OF KANSAS SCHOOL OF MED (KC/WICH/SAL)
Graduated 2009 (17 years in practice)
Group practice Providence Health And Service- Washington — 172 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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