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

Jacqualine R Peterson, SUDPT

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1316887912

Jacqualine R Peterson, SUDPT is an Addiction (Substance Use Disorder) Counselor in Vancouver, Washington. Practices as a sole proprietor. Licensed in Washington.

Licensed in
WA
In the registry since
2026

Practice location Address checks out

1601 E Fourth Plain Blvd Bldg 17
Vancouver, WA 98661-3717
Phone: (360) 397-8246
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X (WA)

Record details

NPI number1316887912
Entity typeIndividual (Type 1)
GenderFemale
Credentials SUDPT
Sole proprietorYes
NPI enumeratedMarch 31, 2026
Last updated in NPPESApril 8, 2026
Certification dateApril 8, 2026

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