Provider Demographics
NPI:1861961450
Name:TADAYA, ARLENE KAY
Entity type:Individual
Prefix:
First Name:ARLENE
Middle Name:KAY
Last Name:TADAYA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7020 W TONTO DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-5534
Mailing Address - Country:US
Mailing Address - Phone:623-330-0357
Mailing Address - Fax:
Practice Address - Street 1:11225 N 28TH DR STE D115K
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85029-5609
Practice Address - Country:US
Practice Address - Phone:623-330-0357
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-13
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care