Jessica Peterson, CDPT

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CO60586697 Issued in WA

Practice address

933 E 1St St
Port Angeles, WA 98362-4012

Phone

(360) 452-4432

Fax

(360) 452-4599

NPI assigned

Jul 11, 2016

Last updated

Jul 11, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lower Elwha Klallam Tribe

  • Health Service Clinic/Center
  • Port Angeles, WA
  • NPI 1841316023
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1468195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468195200000",
    "number": "1295187532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2851 LOWER ELWHA RD",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983638409",
            "telephone_number": "360-452-4432",
            "fax_number": "360-452-4599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "933 E 1ST ST",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983624012",
            "telephone_number": "360-452-4432",
            "fax_number": "360-452-4599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "JESSICA",
        "credential": "CDPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-11",
        "last_updated": "2016-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CO60586697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Jacqueline Perez, RBT, CBT
• Susan L Perkins, LMP
• Rebecca Perron
• Jordanne Perry, RN
• Sarah A Perry, BSW
• Miranda Petruska
• Susan M Petty, PHARM. D.
• Cherie Pfeiffer, LMHC
• Pharmaceutical Systems Inc
• Clinton B Pharris, CO61691834

• Addiction (Substance Use Disorder) Counselor in Port Angeles, WA
• Providers in Port Angeles, WA by specialty
• Addiction (Substance Use Disorder) Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.