1. Home
  2. Directory
  3. Washington
  4. Olympia
  5. Psychologist
  6. NPI Profile

JEFFREY ROBERT PETRA PH.D.
NPI 1487739603
Psychologist - Clinical Child & Adolescent in Olympia, WA

Active since October 26, 2006PECOS Enrolled
1800 COOPER POINT RD SW STE 17, OLYMPIA, WA 98502(360) 754-4662(360) 352-3289 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Jeffrey Robert Petra Ph.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JEFFREY ROBERT PETRA PH.D. (NPI 1487739603) is an individual clinical child & adolescent provider in Olympia, Washington and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS and is a graduate of Other (2000).

NPPES Registry Identity

NPI1487739603
Entity TypeIndividualMale
Primary Taxonomy103TC2200X
Provider Legal NameJEFFREY ROBERT PETRACredential: PH.D.
Location Address1800 COOPER POINT RD SW STE 17Olympia, WA 98502-1179
Mailing AddressPo Box 11009Olympia, WA 98508-1009 · (360) 352-2037 · Fax (360) 352-0637
Phone(360) 754-4662
Fax(360) 352-3289
Sole ProprietorYes
Medical School CMSOtherGraduated 2000
Enumeration DateOctober 26, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1487739603 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · Clinical Child & AdolescentBehavioral Health & Social Service Providers
Taxonomy Code103TC2200X
Definition

A psychologist who develops and applies scientific knowledge to the delivery of psychological services to infants, toddlers, children and adolescents within their social context. Of particular importance to the specialty of clinical child psychology is an understanding of the basic psychological needs of children and adolescents, and how the family and other social contexts influence the socio-emotional adjustment, cognitive development, behavioral adaptation and health status of children and adolescents.

1800 COOPER POINT RD SW STE 17, Olympia, WA 98502
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jeffrey Robert Petra Ph.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4486875580
PECOS Enrollment IDI20141014001394
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GREGORY L. WILLIAMS, PSY.D., PC
Psychologist (Clinical)
1800 COOPER POINT RD SW STE 17
OLYMPIA, WA 98502
Thurston County (360) 754-4662
SCOTT D COLEMAN
Counselor (Mental Health)
1800 COOPER POINT RD SW STE 17
OLYMPIA, WA 98502
Thurston County (360) 352-1668
MS. CHERYL ANN DEVINY LMHC
Counselor (Mental Health)
1800 COOPER POINT RD SW STE 17
OLYMPIA, WA 98502
Thurston County (360) 280-2015
JOHN SHATTUCK LMHC
Counselor (Mental Health)
1800 COOPER POINT RD SW STE 17
OLYMPIA, WA 98502
Thurston County (360) 915-3887
KELLEY SIMMONS JONES LMHC
Counselor (Mental Health)
1800 COOPER POINT RD SW STE 17
OLYMPIA, WA 98502
Thurston County (360) 970-2135
BELIEF CENTER FOR FAMILY THERAPY
Clinic/Center (Mental Health (Including Community Mental Health Center))
1800 COOPER POINT RD SW STE 17
OLYMPIA, WA 98502
Thurston County (360) 451-3405

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jeffrey Petra's NPI number?

The NPI number for Jeffrey Petra is 1487739603. It was assigned to this individual provider in the NPPES registry on October 26, 2006.

Where is Jeffrey Petra located?

Jeffrey Petra practices at 1800 Cooper Point Rd SW Ste 17, Olympia, WA 98502. The listed phone number is (360) 754-4662.

What is Jeffrey Petra's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical Child & Adolescent, with taxonomy code 103TC2200X.

Is Jeffrey Petra enrolled in Medicare?

Yes. Jeffrey Petra is registered in the Medicare PECOS enrollment system.

What insurance does Jeffrey Petra accept?

Health plans from Premera Blue Cross Blue Shield of Alaska list Jeffrey Petra as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jeffrey Petra was last updated on July 8, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.