=====================================================
General NPI Number Information
=====================================================
NPI Number | 1306445283
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARGRET ANNE MARIE PETERSON LMHCA, MA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/21/2020
-----------------------------------------------------
Last Update Date | 09/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11018 NE 18TH ST APT A7
-----------------------------------------------------
City | VANCOUVER
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98684-4331
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-952-9613
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11018 NE 18TH ST APT A7
-----------------------------------------------------
City | VANCOUVER
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98684-4331
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-952-9613
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | MC.70003379
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------