Provider Demographics
NPI:1366608101
Name:PETTEPIECE, CAROLINE MAIER (LMT, LMHCA)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:MAIER
Last Name:PETTEPIECE
Suffix:
Gender:F
Credentials:LMT, LMHCA
Other - Prefix:
Other - First Name:CAROLINE
Other - Middle Name:MAIER
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7209 6TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98117-4940
Mailing Address - Country:US
Mailing Address - Phone:360-789-2812
Mailing Address - Fax:
Practice Address - Street 1:7209 6TH AVE NW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98117-4940
Practice Address - Country:US
Practice Address - Phone:360-789-2812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-31
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00018900225700000X
WA60984750101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist