Provider Demographics
NPI:1831223221
Name:KAPERICK, PETER DAMIAN (MSW)
Entity type:Individual
Prefix:MR
First Name:PETER
Middle Name:DAMIAN
Last Name:KAPERICK
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 1:75 NW DOGWOOD ST STE B
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-3258
Mailing Address - Country:US
Mailing Address - Phone:425-269-3277
Mailing Address - Fax:425-391-1484
Practice Address - Street 1:22717 SE 29TH ST STE D-101
Practice Address - Street 2:
Practice Address - City:SAMMAMISH
Practice Address - State:WA
Practice Address - Zip Code:98075-9532
Practice Address - Country:US
Practice Address - Phone:425-269-3277
Practice Address - Fax:425-392-0944
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2019-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000063511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical