Provider Demographics
NPI:1174175384
Name:PETERSON, MARGARET JANE (MA)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:JANE
Last Name:PETERSON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 S FREYA ST STE 212
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-4871
Mailing Address - Country:US
Mailing Address - Phone:509-368-9863
Mailing Address - Fax:
Practice Address - Street 1:104 S FREYA ST STE 212
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-4871
Practice Address - Country:US
Practice Address - Phone:509-368-9863
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-09
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG60964134101Y00000X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor