Individual
PADEN GONZALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
207 E 12TH ST, EMMETT, ID 83617-3626
(208) 365-1065
Mailing address
1441 NE 10TH AVE, PAYETTE, ID 83661-5420
(208) 642-9376
(208) 642-9279
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
6361826
ID
363A00000X
Physician Assistant
PA224957
OR
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500841600
—
OR
Enumeration date
07/16/2024
Last updated
01/14/2026
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