Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Charles Randolph Petersen

Individual provider Mental Health Counselor · NPI 1417578014

Charles Randolph Petersen is a Mental Health Counselor in Clarkston, Washington. Registered with an NPI since 2020.

In the registry since
2020

Practice location Address checks out

900 7th St
Clarkston, WA 99403-2005
Phone: (508) 758-3341
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X

Record details

NPI number1417578014
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMay 5, 2020
Last updated in NPPESMay 5, 2020
Certification dateMay 5, 2020
Mailing address900 7th St, Clarkston, WA 99403-2005

Other providers in Clarkston