Individual provider Active NPI

Alexandra Katherine Demetro, ND, LM

  • Naturopath
  • Battle Ground, WA
National Provider Identifier
1912019621
Registry record updated Jul 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
NaturopathTaxonomy code 175F00000X
License
NT60254488 Issued in WA
Practice address
404 E Main St
Battle Ground, WA 98604
Phone
(360) 687-0800
Fax
(360) 687-1600
NPI assigned
Aug 31, 2006
Last updated
Jul 25, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Naturopath 175F00000X 1264 OR
Naturopath 175F00000X NT60254488 WA Primary
Midwife 176B00000X MW60259967 WA

Addresses

Primary practice location

404 E Main St
Battle Ground, WA 98604

Mailing address

404 E Main St
Battle Ground, WA 98604
Phone (360) 687-0800

Other identifiers 2

IdentifierTypeStateIssuer
1264OtherND OREGON LICENSE NUMBER
NT 60254488OtherND WASHINGTON LICENSE NUMBER

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

LicenseStateTypeSpecialty
1264ORMDNaturopath
NT60254488WAMDNaturopath
MW60259967WAMDMidwife

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532476800000",
    "number": "1912019621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 E MAIN ST",
            "city": "BATTLE GROUND",
            "state": "WA",
            "postal_code": "98604",
            "telephone_number": "360-687-0800",
            "fax_number": "360-687-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 E MAIN ST",
            "city": "BATTLE GROUND",
            "state": "WA",
            "postal_code": "98604",
            "telephone_number": "360-687-0800",
            "fax_number": "360-687-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMETRO",
        "first_name": "ALEXANDRA",
        "middle_name": "KATHERINE",
        "credential": "ND, LM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2018-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "OR",
            "license": "1264",
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "WA",
            "license": "NT60254488",
            "primary": true
        },
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "WA",
            "license": "MW60259967",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ND OREGON LICENSE NUMBER",
            "identifier": "1264",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ND WASHINGTON LICENSE NUMBER",
            "identifier": "NT 60254488",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Battle Ground, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2018; 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.