Provider Demographics
NPI:1982905980
Name:PETERSON, KATHERINE R (ND)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:R
Last Name:PETERSON
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:8156 S WADSWORTH BLVD # E175
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80128-9114
Mailing Address - Country:US
Mailing Address - Phone:503-313-0003
Mailing Address - Fax:720-293-8577
Practice Address - Street 1:4240 KIPLING ST
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033
Practice Address - Country:US
Practice Address - Phone:303-928-0308
Practice Address - Fax:720-293-8577
Is Sole Proprietor?:No
Enumeration Date:2010-11-06
Last Update Date:2018-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0990072496175F00000X
COND.0000097175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath