ROBERT JOHN TILLEY (NPI# 1114044393) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114044393 |
| Entity Type | Individual |
| Full Name | ROBERT JOHN TILLEY |
| Credential | M.D. |
| Practice Address |
12720 Sw Pacific Hwy Ste 1 Tigard OR 97223-6125 |
| Mailing Address |
12720 Sw Pacific Hwy #1 Tigard OR 97223-6125 |
| Practice Telephone | 5039746170 |
| Practice Fax Number | 5032087198 |
| Mailing Telephone | 5039746170 |
| Mailing Fax Number | 5032087198 |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2012-11-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 14698 | OR | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962504886 | Robert Lee Tilley | Internal Medicine | 1390 Us Highway 61, Suite 2300, Festus, MO 63028-4137 | 2006-09-01 |
| Street Address |
12720 SW PACIFIC HWY STE 1 |
| City | TIGARD |
| State | OR |
| Zip Code | 97223-6125 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801296447 | Inhousedoc | Clinic/Center | 12720 Sw Pacific Hwy Ste 1, Tigard, OR 97223-6125 | 2014-09-02 |
| 1821379223 | Affordable Health Clinics | Clinic/Center | 12720 Sw Pacific Hwy Ste 1, Tigard, OR 97223-6125 | 2011-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760042618 | Tess Ivie Manso | Counselor | 8915 Degrees Center St, Tigard, OR 97223 | 2019-06-13 |
| 1780141804 | Amybrunermd LLC | Obstetrics & Gynecology | 6958 Sw Varns Street, Portland, OR 97223 | 2019-02-25 |
| 1417425034 | Patience Marie Rutto | Counselor | 8915 Sw Center Streret, Tigard, OR 97223 | 2018-11-13 |
| 1871089581 | Marina E Menegol | Behavioral Analyst | Center for Social Dynamics, 9115 Southwest Oleson Rd. Ste. 100, Portland, OR 97223 | 2018-07-05 |
| 1215423165 | Katherine Virginia Eichner | Psychologist | 9860 Sw Hall Blvd Ste B, Tigard, OR 97223 | 2018-07-03 |
| 1043717390 | Rayna Donnelly | Physician Assistant | 9735 Sw Shady Ln Ste 102, Tigard, OR 97223 | 2018-04-11 |
| 1376059725 | Kaylie Marilyn Reyes | Behavioral Analyst | 9115 Sw Oleson Road, Portland, OR 97223 | 2017-12-21 |
| 1841704004 | Kathleen Terrell Taylor | Occupational Therapist | 7320 Sw Hunziker, Suite 203, Tigard, OR 97223 | 2017-11-27 |
| 1487163036 | Susie Riess | Counselor | 10763 Sw Greenburg Road, Suite 100, Tigard, OR 97223 | 2017-09-27 |
| 1043731243 | Tam Nguyen | Optometrist | 8795 Sw Scholls Ferry Rd Ste 100, Tigard, OR 97223 | 2017-06-28 |
| Find all providers in zip 97223 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982671350 | Joyce L Lee | General Practice | 7175 Sw Beveland Rd, Ste 205, Tigard, OR 97223-8665 | 2006-03-03 |
| 1205226214 | Landmark Health of Oregon LLC | General Practice | 9020 Sw Washington Square Rd, Suite 100, Tigard, OR 97223-4436 | 2015-01-28 |
| 1437576410 | Timothy Ryan Beals | General Practice | 7300 Sw Childs Rd, #b, Tigard, OR 97224 | 2014-03-27 |
| 1134337314 | Jerry Roy Darm | General Practice | 9735 Sw Shady Ln, #203, Tigard, OR 97223-5481 | 2007-05-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285234674 | Sme Hawaii PC Inc | General Practice | 6021 Se Heike St, Hillsboro, OR 97123-8296 | 2020-10-27 |
| 1194223107 | Landmark Connect of Oregon PC | General Practice | 5933 Ne Win Sivers Dr Ste 310, Portland, OR 97220 | 2018-01-24 |
| 1346751443 | Providence Health & Services Oregon | General Practice | 4400 Ne Halsey St, Pop 2, 3rd Floor, Portland, OR 97213-1545 | 2017-10-16 |
| 1801333901 | Kaiser Foundation Health Plan of The Northwest | General Practice | 3175 Nw Aloclek Dr, Hillsboro, OR 97124-7135 | 2017-01-26 |
| 1336697143 | Rita Lawler | General Practice | 8353 Se Clatsop Ct, Portland, OR 97266-6159 | 2016-09-21 |
| 1821541939 | Samuel R. Sabo | General Practice | 18171 Waldow Rd., Oregon City, OR 97045 | 2016-07-26 |
| 1659730760 | Propel Network, LLC | General Practice | 14525 Sw Millikan Way, Beaverton, OR 97005-2343 | 2016-02-17 |
| 1235526849 | Hollis Lule Augee | General Practice | 5151 S.w. 88th Ave., Portland, OR 97225-1717 | 2015-04-21 |
| 1023428034 | Victoria L. Larson | General Practice | 10,000 Se 222nd Ave., Damascus, OR 97089-6517 | 2014-04-29 |
| 1093134496 | Red Leaf Natural Health Clinic | General Practice | 833 Sw 11th Ave Ste 1018, Portland, OR 97205-2124 | 2014-04-14 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.