Individual
JAIME PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3710 N MONROE ST, SPOKANE, WA 99205-2850
(509) 328-5234
Mailing address
3710 N MONROE ST, SPOKANE, WA 99205-2850
(509) 328-5234
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP00006388
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32035100
—
WA
Enumeration date
09/25/2018
Last updated
09/25/2018
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