Individual
MR. BRADLEY LEWIS PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMHC
Contact information
Practice address
11105 NE 14TH ST, SUITE 103, VANCOUVER, WA 98684-4308
(360) 980-7906
(360) 326-1859
Mailing address
11105 NE 14TH ST, SUITE 103, VANCOUVER, WA 98684-4308
(360) 980-7906
(360) 326-1859
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LH60172629
WA
Other
Enumeration date
03/11/2011
Last updated
04/20/2016
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