Provider Demographics
NPI:1609993344
Name:SNELL, PETER (MSW)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:SNELL
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4010 HENDERSON BLVD SE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98501-4245
Mailing Address - Country:US
Mailing Address - Phone:360-339-2988
Mailing Address - Fax:360-596-9027
Practice Address - Street 1:2530 NE KRESKY AVE
Practice Address - Street 2:SUITE B-1
Practice Address - City:CHEHALIS
Practice Address - State:WA
Practice Address - Zip Code:98532-2406
Practice Address - Country:US
Practice Address - Phone:360-339-2988
Practice Address - Fax:360-596-9027
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2015-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC000420211041C0700X
WALW601177601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical