Provider Demographics
NPI:1528028446
Name:PETER SCHEENSTRA MSW INC
Entity Type:Organization
Organization Name:PETER SCHEENSTRA MSW INC
Other - Org Name:NONE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PSYCOTHERAPIST
Authorized Official - Prefix:PROF
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHEENSTRA
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:425-451-0112
Mailing Address - Street 1:1621 114TH AVE SE,SUITE 224
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004
Mailing Address - Country:US
Mailing Address - Phone:425-451-0112
Mailing Address - Fax:424-450-5561
Practice Address - Street 1:1621 114TH AVE SE
Practice Address - Street 2:SUITE 224
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004
Practice Address - Country:US
Practice Address - Phone:425-451-0112
Practice Address - Fax:424-450-5561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW00005292251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management