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General NPI Number Information
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NPI Number | 1366623456
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Entity Type | Individual
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Provider Name | PETER JOHN LEFEAU M.S.W.
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Gender | Male
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Dates
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Enumeration Date | 11/17/2007
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Last Update Date | 12/11/2007
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Provider Practice Location Address
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Address Line | 113 170TH ST S
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City | SPANAWAY
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State | WA
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Zip | 98387-8222
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Country | US
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Telephone | 253-535-1935
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Fax |
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Provider Business Mailing Address
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Address Line | 9330 59TH AVE SW
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City | LAKEWOOD
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State | WA
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Zip | 98499-2858
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Country | US
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Telephone | 253-581-7020
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | RC00042547
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License Number State | WA
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