Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | MD16181 | OR |
N | 207PE0004X | Emergency Medical Services | MD16181 | OR |
N | 207PP0204X | Pediatric Emergency Physician | MD16181 | OR |
NPI | 1588762413 |
---|---|
Provider Name | Craig Warden |
First Address | Portland, OR 97239-3011 |
Second Address | Portland, OR 97239-3011 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2006 |
Last Update Date | 08/07/2007 |