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

Sean Luke Peterson, MD

Individual provider Surgery Physician · NPI 1619362001

Sean Luke Peterson, MD is a General Surgery in Clackamas, Oregon. Graduated from University of Wisconsin School of Medicine in 2015, 11 years ago. Practices with Kaiser Foundation Health Plan of the Northwest, a 1,811-clinician group and accepts Medicare assignment. Licensed in Iowa, Minnesota, Oregon and Washington and 1 more.

Years since qualifying
11
Trained at
University of Wisconsin School of Medicine
Licensed in
IA, MN, OR, WA, WI
In the registry since
2015
Specialties on file
6
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

10180 SE Sunnyside Rd Ofc Egs
Clackamas, OR 97015-8970
Phone: (503) 813-2000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence MD201352 (OR)
Surgery Physician Taxonomy 208600000X · Licence MD61103323 (WA)
Surgery Physician Taxonomy 208600000X · Licence 63579 (MN)
Surgery Physician Taxonomy 208600000X · Licence MD47700 (IA)
Surgery Physician Taxonomy 208600000X · Licence 73695-20 (WI)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1619362001
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 2, 2015
Last updated in NPPESDecember 2, 2021
Certification dateDecember 2, 2021
Mailing address10180 Se Sunnyside Rd Ofc, Clackamas, OR 97015-8970

Medicare enrollment

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

Medicare specialtyGENERAL SURGERY
Medical schoolUNIVERSITY OF WISCONSIN SCHOOL OF MEDICINE
Graduated 2015 (11 years in practice)
Group practice Kaiser Foundation Health Plan Of The Northwest — 1811 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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