Individual
FRITZ CHARLES PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CDP(T)
Contact information
Practice address
614 PETERSON RD, BURLINGTON, WA 98233-2606
(360) 757-0131
(360) 757-0136
Mailing address
614 PETERSON RD, BURLINGTON, WA 98233-2606
(360) 757-0131
(360) 757-0136
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO60521386
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CO60521386
CHEMICAL DEPENDENCY PROFESSIONAL (TRAINEE)
WA
Enumeration date
03/27/2015
Last updated
03/27/2015
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