Peterson, Robert John

Peterson, Robert John is an sole proprietor health care provider with primary practice located at 40647 Lake Rd , Loon Lake WA 99148-9795. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Social Worker. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Peterson, Robert John can be contacted via phone (509) 939-5515.

Contact Information

Primary practice address
40647 Lake Rd Loon Lake WA 99148-9795
Phone: (509) 939-5515
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 60174553 Washington
Behavioral Health & Social Service Providers / Social Worker 104100000X X-06759 New Mexico

Profile Details

NPI number 1922336684
LBN Legal business name Peterson, Robert John
Credentials LICSW
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 18th, 2009
Last updated Nov 9th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922336684 NPPES
New Mexico Other 336712 PED LICENSE
New Mexico Other X-06759 PED LICENSE

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