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1417578014
CHARLES RANDOLPH PETERSEN
CLARKSTON, WA
NPI
1417578014
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Professional Name
PETE PETERSEN
Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2020-05-05
Last Update Date
2020-05-05
Business Address
CHARLES RANDOLPH PETERSEN
900 7TH ST
CLARKSTON, WA 99403-2005
Phone number: 508-758-3341
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Mailing Address
CHARLES RANDOLPH PETERSEN
900 7TH ST
CLARKSTON, WA 99403-2005
Phone number: 508-758-3341
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