Karen Renee Peterson, ND, LAC
Individual provider Active NPI Naturopath · Carson, NM
NPI 1043633217 · NPPES record last updated Oct 22, 2023
Key facts
- NPI
- 1043633217
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Naturopath 175F00000X
- License
- ND2023-0024 (NM)
- Practice address
- 102 W Rim Rd
Carson, NM 87517-8099 - Phone
- (503) 774-2857
- NPI assigned
- Jan 24, 2014
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ACU0002826 | CO | MD | Acupuncturist |
| AC164788 | OR | MD | Acupuncturist |
| ND2023-0024 | NM | MD | Naturopath |
| 2017 | OR | MD | Naturopath |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | AC164788 | OR | |
| Acupuncturist | 171100000X | ACU0002826 | CO | |
| Naturopath | 175F00000X | 2017 | OR | |
| Naturopath | 175F00000X | ND2023-0024 | NM | Yes |
Addresses
Primary practice location
102 W Rim Rd
Carson, NM 87517-8099
Mailing address
PO Box 841
Taos, NM 87571-0841
Phone (503) 774-2857
Other practice location 1
6542 SE 50th Ave
Portland, OR 97206-7626
Phone (503) 774-2857
Other practice location 2
102 W Rim Rd
Carson, NM 87517-8099
Phone (503) 774-2857
Other providers in Carson, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 22, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.