Provider Demographics
NPI:1699922195
Name:NOMIDES, PETER
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:NOMIDES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16150 NE 85TH ST STE 222
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-3546
Mailing Address - Country:US
Mailing Address - Phone:425-869-6687
Mailing Address - Fax:877-880-4388
Practice Address - Street 1:16150 NE 85TH ST STE 222
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3546
Practice Address - Country:US
Practice Address - Phone:425-869-6687
Practice Address - Fax:877-880-4388
Is Sole Proprietor?:No
Enumeration Date:2008-08-26
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000059051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical