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NPI 1003769779

IndividualActive

Ethan Oftedahl

NPI 1003769779 · Peer Specialist · Fargo, ND

Provider details

NPI number: 1003769779
Entity type: Individual
Primary specialty: Peer SpecialistOther Service Providers
Sole proprietor: No
License: 837 (ND)

Practice location

921 2nd Ave S

Fargo, ND 58103-1705

Phone: (701) 361-9922

Fax: (701) 829-7140

More ND providers

Mailing address

921 2nd Ave S

Fargo, ND 58103-1705

Registry dates

Enumerated: 2026-02-20
Last updated: 2026-02-20

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

Ethan Oftedahl — NPI 1003769779, Fargo, ND | NPI Central