Healthcare Provider Details

I. General information

NPI: 1083737050
Provider Name (Legal Business Name): SONJA TVEIT-PETTERSEN N.M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16601 N 90TH ST
SCOTTSDALE AZ
85260-2794
US

IV. Provider business mailing address

16601 N 90TH ST
SCOTTSDALE AZ
85260-2794
US

V. Phone/Fax

Practice location:
  • Phone: 480-502-5398
  • Fax:
Mailing address:
  • Phone: 480-502-5398
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number03-748
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: