Provider Demographics
NPI:1891832309
Name:CHRISTIANSON, ALAN GLEN (NMD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:GLEN
Last Name:CHRISTIANSON
Suffix:
Gender:M
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9393 N 90TH ST STE 102624
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-5040
Mailing Address - Country:US
Mailing Address - Phone:480-657-0003
Mailing Address - Fax:408-657-8693
Practice Address - Street 1:9200 E RAINTREE DR
Practice Address - Street 2:# 100
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-7308
Practice Address - Country:US
Practice Address - Phone:480-657-0003
Practice Address - Fax:408-657-8693
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ474-96175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath