Individual
JAYSON LEE PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.ED., LMFT
Contact information
Practice address
492 E 13TH AVE STE 105, EUGENE, OR 97401
(541) 579-9288
Mailing address
492 E 13TH AVE STE 105, EUGENE, OR 97401-4250
(541) 579-9288
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
T1229
OR
Other
Enumeration date
10/11/2011
Last updated
06/22/2018
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