Provider Demographics
NPI:1457719387
Name:PARADIS, ASHLIE MARIE (CNA)
Entity Type:Individual
Prefix:
First Name:ASHLIE
Middle Name:MARIE
Last Name:PARADIS
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5436 BURBANK ST N
Mailing Address - Street 2:
Mailing Address - City:KEIZER
Mailing Address - State:OR
Mailing Address - Zip Code:97303-7621
Mailing Address - Country:US
Mailing Address - Phone:505-850-8682
Mailing Address - Fax:
Practice Address - Street 1:5436 BURBANK ST N
Practice Address - Street 2:
Practice Address - City:KEIZER
Practice Address - State:OR
Practice Address - Zip Code:97303-7621
Practice Address - Country:US
Practice Address - Phone:505-850-8682
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-06
Last Update Date:2016-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201503026CNA376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide