Provider Demographics
NPI:1114123684
Name:ARDEN, EMILIA (DO)
Entity Type:Individual
Prefix:
First Name:EMILIA
Middle Name:
Last Name:ARDEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 4TH ST
Mailing Address - Street 2:PO BOX 460
Mailing Address - City:LA GRANDE
Mailing Address - State:OR
Mailing Address - Zip Code:97850-1906
Mailing Address - Country:US
Mailing Address - Phone:541-963-2328
Mailing Address - Fax:541-975-5210
Practice Address - Street 1:506 4TH ST
Practice Address - Street 2:
Practice Address - City:LA GRANDE
Practice Address - State:OR
Practice Address - Zip Code:97850-1906
Practice Address - Country:US
Practice Address - Phone:541-963-2328
Practice Address - Fax:541-975-5210
Is Sole Proprietor?:No
Enumeration Date:2007-06-22
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDO24686207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease