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Organization
PACIFIC CREST COUNSELING CENTER LLC
Active
Organization
PACIFIC CREST COUNSELING CENTER LLC
Active
Other names
Innerwork Counseling Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAYMOND W PETERSON PH.D., L.P.C. (CLINICAL DIRECTOR)
(503) 223-7719
Entity
Organization
Contact information
Practice address
8035 NE PRESCOTT ST, PORTLAND, OR 97218-4249
(503) 223-7719
(503) 255-4714
Mailing address
8035 NE PRESCOTT ST, PORTLAND, OR 97218-4249
(503) 223-7719
(503) 255-4714
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
04/10/2008
Last updated
04/14/2009
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