Individual
MR. DONALD E. PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ADDICTION THERAPIST
Contact information
Practice address
1601 E 4TH PLAIN BLVD, VANCOUVER, WA 98661-3753
(360) 696-4061
(360) 750-5385
Mailing address
1601 E 4TH PLAIN BLVD, VANCOUVER, WA 98661-3753
(360) 696-4061
(360) 750-5385
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
97-04-51
OR
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP00002039
WA
Other
Enumeration date
07/18/2008
Last updated
07/18/2008
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