Individual provider · Type 1 NPI

Markell Petersen, SUDP

Addiction (Substance Use Disorder) Counselor · Vancouver, WA

NPI number 1104383645 Active

Practice location

7700 NE 26th Ave
Vancouver, WA 98665-0672

Call (360) 397-8228 Map

Fax (360) 397-8251

Mailing address

PO Box 2429
Longview, WA 98632-8486

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X61146194 (WA)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1104383645

Markell Petersen, SUDP's National Provider Identifier is 1104383645, issued on Feb 20, 2019. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Vancouver, WA. The record was last updated on Jul 10, 2024.