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ETHAN OFTEDAHL
NPI 1003769779
Peer Specialist in Fargo, ND

Active since February 20, 2026
921 2ND AVE S, FARGO, ND 58103(701) 361-9922(701) 829-7140 Get Directions Write a Review

NPPES record last updated: February 20, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ethan Oftedahl NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ETHAN OFTEDAHL (NPI 1003769779) is an individual peer specialist in Fargo, North Dakota, licensed in North Dakota (837) and active in the NPI registry since February 2026.

NPPES Registry Identity

NPI1003769779
Entity TypeIndividual
Primary Taxonomy175T00000X
Provider Legal NameETHAN OFTEDAHL
Location Address921 2ND AVE SFargo, ND 58103-1705
Mailing Address921 2nd Ave SFargo, ND 58103-1705 · (701) 361-9922 · Fax (701) 829-7140
Phone(701) 361-9922
Fax(701) 829-7140
Sole ProprietorNo
Enumeration DateFebruary 20, 2026
NPPES CertifiedFebruary 20, 2026
✔ NPI 1003769779 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPeer SpecialistOther Service Providers
Taxonomy Code175T00000X
License✔ Licensed in ND · 837
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
921 2ND AVE S, Fargo, ND 58103
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KRIS STROUSE
Peer Specialist
921 2ND AVE S
FARGO, ND 58103
Cass County (701) 361-9922
MILLENNIUM FALCON
Peer Specialist
921 2ND AVE S
FARGO, ND 58103
Cass County (701) 361-9922
LIGHT HOUSE RECOVERY SERVICES
Community/Behavioral Health
921 2ND AVE S
FARGO, ND 58103
Cass County (701) 361-9922
SHANE KAYESKA
Peer Specialist
921 2ND AVE S
FARGO, ND 58103
Cass County (701) 361-9922
JAMIE MABE
Peer Specialist
921 2ND AVE S
FARGO, ND 58103
Cass County (701) 361-9922
NICHOLAS ERIC SENN
Peer Specialist
921 2ND AVE S
FARGO, ND 58103
Cass County (701) 361-9922
HEAVENLY LACE MABE
Peer Specialist
921 2ND AVE S
FARGO, ND 58103
Cass County (701) 318-8204
SHAUNTE BROWNOTTER
Peer Specialist
921 2ND AVE S
FARGO, ND 58103
Cass County (701) 318-8204

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ethan Oftedahl's NPI number?

The NPI number for Ethan Oftedahl is 1003769779. It was assigned to this individual provider in the NPPES registry on February 20, 2026.

Where is Ethan Oftedahl located?

Ethan Oftedahl practices at 921 2nd Ave S, Fargo, ND 58103. The listed phone number is (701) 361-9922.

What is Ethan Oftedahl's specialty?

The primary specialty registered for this NPI is Peer Specialist with taxonomy code 175T00000X.

When was this NPI record last updated?

The NPPES record for Ethan Oftedahl was last updated on February 20, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.