# ADULT BEHAVIORAL HEALTH CARE

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528874377
- **Authorized official:** TOD C PETERSON CNP (OWNER)
- **Authorized official phone:** (360) 605-2350

## Contact information

- **Practice address:** 8807 E MILL PLAIN BLVD, VANCOUVER, WA 98664-2532
- **Practice address phone:** (360) 605-2350
- **Practice address fax:** (360) 991-0010
- **Mailing address:** PO BOX 871327, VANCOUVER, WA 98687-1327
- **Mailing address phone:** (360) 605-2350
- **Mailing address fax:** (360) 991-0010

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 12/06/2024
- **Last updated:** 12/09/2024