Provider Demographics
NPI:1003122920
Name:ALDAL, PATRICIA SNOW
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:SNOW
Last Name:ALDAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:SNOW
Other - Last Name:GILBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:2188 N DANEBO AVE
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97402-1240
Mailing Address - Country:US
Mailing Address - Phone:541-359-6564
Mailing Address - Fax:
Practice Address - Street 1:2188 N DANEBO AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-1240
Practice Address - Country:US
Practice Address - Phone:541-359-6564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-30
Last Update Date:2015-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201030307LPN164W00000X
OR200812356CNA376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No376K00000XNursing Service Related ProvidersNurse's Aide