Healthcare Provider Details

I. General information

NPI: 1083329221
Provider Name (Legal Business Name): TATIANA ARIEL HARDEN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TATIANA GIL

II. Dates (important events)

Enumeration Date: 01/23/2023
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1430 MONMOUTH ST
INDEPENDENCE OR
97351-1127
US

IV. Provider business mailing address

1430 MONMOUTH ST
INDEPENDENCE OR
97351-1127
US

V. Phone/Fax

Practice location:
  • Phone: 503-917-2255
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number10011012
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number266359
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number10011012
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: