Provider Demographics
NPI:1376979518
Name:MORALES, PETRA MARIA (MSW)
Entity Type:Individual
Prefix:
First Name:PETRA
Middle Name:MARIA
Last Name:MORALES
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 WALLACE WAY
Mailing Address - Street 2:
Mailing Address - City:GRANDVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98930
Mailing Address - Country:US
Mailing Address - Phone:509-882-3444
Mailing Address - Fax:509-882-0329
Practice Address - Street 1:1000 WALLACE WAY
Practice Address - Street 2:
Practice Address - City:GRANDVIEW
Practice Address - State:WA
Practice Address - Zip Code:98930
Practice Address - Country:US
Practice Address - Phone:509-882-3444
Practice Address - Fax:509-882-0329
Is Sole Proprietor?:No
Enumeration Date:2013-09-19
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor