Provider Demographics
NPI:1982877841
Name:WORDEN, CYNTHIA M (DO LLC)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:M
Last Name:WORDEN
Suffix:
Gender:F
Credentials:DO LLC
Other - Prefix:DR
Other - First Name:CYNTHIA
Other - Middle Name:M
Other - Last Name:WORDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:15 82ND DR STE 100
Mailing Address - Street 2:
Mailing Address - City:GLADSTONE
Mailing Address - State:OR
Mailing Address - Zip Code:97027-2550
Mailing Address - Country:US
Mailing Address - Phone:503-953-0126
Mailing Address - Fax:
Practice Address - Street 1:15 82ND DR STE 100
Practice Address - Street 2:
Practice Address - City:GLADSTONE
Practice Address - State:OR
Practice Address - Zip Code:97027-2550
Practice Address - Country:US
Practice Address - Phone:503-831-9231
Practice Address - Fax:503-656-8080
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-10
Last Update Date:2018-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDO27930207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine