Provider Demographics
NPI:1699566018
Name:OTTEN, ANDREW STEPHEN (ND)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:STEPHEN
Last Name:OTTEN
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:545 N OCOTILLO DR # MH23
Mailing Address - Street 2:
Mailing Address - City:APACHE JUNCTION
Mailing Address - State:AZ
Mailing Address - Zip Code:85120-5327
Mailing Address - Country:US
Mailing Address - Phone:513-544-1880
Mailing Address - Fax:
Practice Address - Street 1:312 N ALMA SCHOOL RD STE 17
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-4354
Practice Address - Country:US
Practice Address - Phone:480-331-5044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-15
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ25-1942175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath