Individual
DR. MARY PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
414 N MERIDIAN ST, BOX 6275, NEWBERG, OR 97132-2697
(503) 554-2377
Mailing address
212 HILLTOP DR, NEWBERG, OR 97132-9027
(503) 538-2831
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1671
OR
Other
Enumeration date
01/05/2007
Last updated
07/08/2007
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