Provider Demographics
NPI:1447401393
Name:PATRICK R. ARDEN D.C.P.C.
Entity Type:Organization
Organization Name:PATRICK R. ARDEN D.C.P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:ARDEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:503-769-2801
Mailing Address - Street 1:170 E WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:STAYTON
Mailing Address - State:OR
Mailing Address - Zip Code:97383-1755
Mailing Address - Country:US
Mailing Address - Phone:503-769-2801
Mailing Address - Fax:
Practice Address - Street 1:170 E WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:STAYTON
Practice Address - State:OR
Practice Address - Zip Code:97383-1755
Practice Address - Country:US
Practice Address - Phone:503-769-2801
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-08
Last Update Date:2008-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1545261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care