Provider Demographics
NPI:1336185677
Name:GAEDEKE, LEAH WESTERDAHL (MSN, FNP-C)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:WESTERDAHL
Last Name:GAEDEKE
Suffix:
Gender:F
Credentials:MSN, FNP-C
Other - Prefix:
Other - First Name:LEAH
Other - Middle Name:PAULINE
Other - Last Name:WESTERDAHL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1648
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97440-1648
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:600 COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2240
Practice Address - Country:US
Practice Address - Phone:541-228-3400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2025-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024165811363L00000X
OR200450116NP-PP363LA2100X
OR200450116NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORP00818471OtherRR MEDICARE - PHS
OR272568Medicaid
Q06752Medicare UPIN
OR272568Medicaid
ORR168820Medicare PIN