Individual
JEFFREY ROBERT PETRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1800 COOPER POINT RD SW STE 17, OLYMPIA, WA 98502-1179
(360) 754-4662
(360) 352-3289
Mailing address
PO BOX 11009, OLYMPIA, WA 98508-1009
(360) 352-2037
(360) 352-0637
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
—
Other
Enumeration date
10/26/2006
Last updated
07/08/2007
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