Individual provider · Type 1 NPI

Marlys Ann Petersen, MA

Mental Health Counselor · Portland, OR

NPI number 1134510316 Active

Practice location

8325 SW 61st Ave
Portland, OR 97219-3109

Call (503) 867-9913 Map

Mailing address

PO Box 80524, SW Picasso Place
Portland, OR 97280-1524

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1134510316

Marlys Ann Petersen, MA's National Provider Identifier is 1134510316, issued on Feb 10, 2015. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Portland, OR. The record was last updated on Feb 10, 2015.