Individual
MARKELL PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SUDP
Contact information
Practice address
7700 NE 26TH AVE, VANCOUVER, WA 98665-0672
(360) 397-8228
(360) 397-8251
Mailing address
PO BOX 2429, LONGVIEW, WA 98632-8486
(360) 353-9494
(360) 353-9440
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
61146194
WA
Other
Enumeration date
02/20/2019
Last updated
07/10/2024
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