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Search › Oregon › 213ES0103X

Justin Tidwell, DPM

NPI 1710908892 · on the registry since 2006 · sole proprietor

Practice

Address
501 N Graham St
Suite 415
Portland, OR 97227
Phone
(503) 413-2005
Fax
(503) 413-3699
Organisation at this address
Rdc, Llc
Women'S Clinic Pc
Pacific Surgical Pc
Surgical Center, Inc
The Urology Clinic Pc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
186

Registry record

Primary taxonomy
213ES0103X
213ES0103X
Also registered as
213ES0103X
Licence states on file
WA, OR
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2007-07-08

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oregon