Individual
MRS. LISA MAE PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CP60535132
Contact information
Practice address
1905 4TH AVE E STE B, OLYMPIA, WA 98506-4631
(360) 338-0600
(360) 338-0601
Mailing address
3510 STEELHAMMER DR, CENTRALIA, WA 98531-4551
(360) 623-8020
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP60535132
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2107411
—
WA
Enumeration date
09/18/2015
Last updated
10/26/2022
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