Healthcare Provider Details

I. General information

NPI: 1366366536
Provider Name (Legal Business Name): SHARON G ALDEN-SVENSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2026
Last Update Date: 08/08/2026
Certification Date: 08/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 MIDDLEFORK RD
GARDEN VALLEY ID
83622-5007
US

IV. Provider business mailing address

509 MIDDLEFORK RD
GARDEN VALLEY ID
83622-5007
US

V. Phone/Fax

Practice location:
  • Phone: 208-860-7811
  • Fax:
Mailing address:
  • Phone: 208-860-7811
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: