Provider Demographics
NPI:1609675545
Name:PETERS, ARIELLE (BS)
Entity type:Individual
Prefix:
First Name:ARIELLE
Middle Name:
Last Name:PETERS
Suffix:
Gender:
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25117 52ND AVE E
Mailing Address - Street 2:
Mailing Address - City:GRAHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98338-9539
Mailing Address - Country:US
Mailing Address - Phone:253-230-1736
Mailing Address - Fax:
Practice Address - Street 1:25117 52ND AVE E
Practice Address - Street 2:
Practice Address - City:GRAHAM
Practice Address - State:WA
Practice Address - Zip Code:98338-9539
Practice Address - Country:US
Practice Address - Phone:253-230-1736
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty