MARKELL PETERSEN SUDP NPI 1104383645

NPI Information

  • NPI: 1104383645
  • Provider Name: MARKELL PETERSEN, SUDP
  • Classification: Counselor - 101YA0400X
  • Specialization: Addiction (Substance Use Disorder)
  • Entity Type: Individual
  • Address: 7700 NE 26TH AVE
    VANCOUVER, WA
    ZIP 98665
  • Phone: (360) 397-8228

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NPI Details

Markell Petersen, SUDP is an addiction (substance use disorder) counselor in Vancouver, WA. Markell Petersen, SUDP NPI is 1104383645. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

7700 NE 26TH AVE
VANCOUVER, WA
ZIP 98665-672
Phone: (360) 397-8228
Fax: (360) 397-8251

The enumeration date for this NPI number is 2/20/2019 and was last updated on 7/10/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YA0400XCounselorAddiction (Substance Use Disorder)61146194WASHINGTONYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

NPI Synchronization or Removal

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