Most Relevant Information
Provider Data
| NPI Number: | 1003579095 |
| Provider Name: | NICHOLAS W PETERS |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/18/2021 |
| Last Updated: | 10/18/2021 |
Provider Practice Location
2700 SIMPSON AVE
ABERDEEN
WA
985204335
Practice Location Phone/Fax
| Phone: | 3606120012 |
| Fax: | 3603520670 |
Provider Mailing Location
PO BOX 1847
LONGVIEW
WA
986328140
Provider Mailing Phone/Fax
| Phone: | 3604230203 |
| Fax: | 3605770187 |