Provider Demographics
NPI:1730285396
Name:PETIT, GEOFFREY CHARLES (MSW)
Entity Type:Individual
Prefix:MR
First Name:GEOFFREY
Middle Name:CHARLES
Last Name:PETIT
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 1:15026 40TH AVE W APT 2-201
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98087-8953
Mailing Address - Country:US
Mailing Address - Phone:206-277-6069
Mailing Address - Fax:206-768-5309
Practice Address - Street 1:1660 S COLUMBIAN WAY
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98108-1532
Practice Address - Country:US
Practice Address - Phone:206-277-6069
Practice Address - Fax:207-768-5309
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist