Peter Konstantine Raisanen, NMD

Primary specialty

NaturopathTaxonomy code 175F00000X

License

17-1688 Issued in AZ

Practice address

10444 N 69TH St Apt 101
Paradise Valley, AZ 85253-1453

Phone

(480) 256-2436

Fax

(833) 986-0103

NPI assigned

Jan 6, 2017

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1483660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587686400000",
    "number": "1003352683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10444 N 69TH ST # 101",
            "city": "PARADISE VALLEY",
            "state": "AZ",
            "postal_code": "852531452",
            "telephone_number": "480-256-2436",
            "fax_number": "833-986-0103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10444 N 69TH ST APT 101",
            "city": "PARADISE VALLEY",
            "state": "AZ",
            "postal_code": "852531453",
            "telephone_number": "480-256-2436",
            "fax_number": "833-986-0103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAISANEN",
        "first_name": "PETER",
        "middle_name": "KONSTANTINE",
        "name_prefix": "Dr.",
        "credential": "NMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-01-06",
        "last_updated": "2020-04-24",
        "certification_date": "2020-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "AZ",
            "license": "17-1688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Naturopath in Paradise Valley, AZ
• Providers in Paradise Valley, AZ by specialty
• Naturopath in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.