Active NPI
Jason Mark Petersen, ND
- Naturopath
- Seattle, WA
National Provider Identifier
1194984385
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Naturopath
- License
- NT 60124121
- Practice address
- 200 1St Ave W
Ste 405
Seattle, WA 98119-4298 - Phone
- (206) 295-7554
- NPI assigned
- Jun 3, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Naturopath | 175F00000X | NT 60124121 | WA | Primary |
Addresses
Primary practice location
200 1St Ave W
Ste 405
Seattle, WA 98119-4298
Mailing address
200 1St Ave W
Ste 405
Seattle, WA 98119-4298
Phone (206) 295-7554
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NT 60124121 | WA | MD | Naturopath |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212451200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280707200000",
"number": "1194984385",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 1ST AVE W",
"address_2": "STE 405",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981194298",
"telephone_number": "206-295-7554"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 1ST AVE W",
"address_2": "STE 405",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981194298",
"telephone_number": "206-295-7554"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSEN",
"first_name": "JASON",
"middle_name": "MARK",
"name_prefix": "Dr.",
"credential": "ND",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-06-03",
"last_updated": "2010-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "175F00000X",
"taxonomy_group": "",
"desc": "Naturopath",
"state": "WA",
"license": "NT 60124121",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.