Provider Demographics
NPI:1770753139
Name:HARRIS, PETER H (MS, NBCC, LMHC)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:H
Last Name:HARRIS
Suffix:
Gender:M
Credentials:MS, NBCC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2021 MINOR AVE E
Mailing Address - Street 2:SUITE 3
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98102-3513
Mailing Address - Country:US
Mailing Address - Phone:206-322-2046
Mailing Address - Fax:
Practice Address - Street 1:2021 MINOR AVE E
Practice Address - Street 2:SUITE 3
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-3513
Practice Address - Country:US
Practice Address - Phone:206-322-2046
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-01
Last Update Date:2008-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00004573101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health