JUSTIN ALAN TIDWELL


Address: 501 N Graham St, Suite 415, Portland, OR 97227-1654
Phone: 5034132005

JUSTIN ALAN TIDWELL (NPI# 1710908892) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1710908892
Entity Type Individual
Full Name JUSTIN ALAN TIDWELL
Credential DPM
Practice Address 501 N Graham St
Suite 415
Portland
OR 97227-1654
Mailing Address 5815 Ne 23rd Ave
Portland
OR 97211-5447
Practice Telephone 5034132005
Practice Fax Number 5034133699
Mailing Telephone 5039367454
Enumeration Date 2006-07-22
Last Update Date 2007-07-08
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 213ES0103X Podiatrist
Specialization: Foot & Ankle Surgery
DP00373 OR Podiatric Medicine & Surgery Service Providers
N 213ES0103X Podiatrist
Specialization: Foot & Ankle Surgery
PO00000806 WA Podiatric Medicine & Surgery Service Providers

Other Providers JUSTIN TIDWELL

NPI Name Taxonomy Address Enumeration
1639199862 Justin Tidwell Emergency Medicine 604 Indiana, Lubbock, TX 79415 2006-07-20
1245648922 Justin Tidwell Nurse Practitioner 2333 Buchanan St, San Francisco, CA 94115-1925 2014-07-26

Office Location

Street Address 501 N GRAHAM ST
SUITE 415
City PORTLAND
State OR
Zip Code 97227-1654

Providers in the same location

NPI Name Taxonomy Address Enumeration
1508869157 Paula Deanne Dietsch Kuiper Physician Assistant 501 N Graham St, Suite 220, Portland, OR 97227-1654 2005-05-27
1811454432 Matthew James Luttrell Registered Nurse 501 N Graham St, Portland, OR 97227-1654 2019-03-01
1831640267 Morgan Sue Huey Physician Assistant 501 N Graham St, Suite 415, Portland, OR 97227-1654 2016-10-20
1093169583 Theresa Mcsherry Nurse Practitioner 501 N Graham St, Suite 555, Portland, OR 97227-1654 2016-04-20
1093172702 Jeremy Alper Pharmacist 501 N Graham St, Portland, OR 97227-1654 2016-01-26
1003287269 Evergreen Prosthetics and Orthotics, LLC Durable Medical Equipment & Medical Supplies 501 N Graham St, Ste 255, Portland, OR 97227-1654 2015-10-14
1316321110 Portland Ear, Nose & Throat Specialists Specialist 501 N Graham St, Suite 455, Portland, OR 97227-1654 2015-07-13
1942693908 Leigh Warsing Physician Assistant 501 N Graham St, Suite 580, Portland, OR 97227-1654 2015-03-13
1134521909 Justin Hadaller Physician Assistant 501 N Graham St, Suite 580, Portland, OR 97227-1654 2014-09-23
1932542503 Erica T Ballard Physician Assistant 501 N Graham St, Ste 200, Portland, OR 97227-1654 2013-04-12
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1508466574 Jessica Michelle Simonetti Psychologist Portland Psychotherapy Clinic, Research and Training Ce, 3700 N Williams Ave, Portland, OR 97227 2020-10-29
1447812268 Maksim Yefimov Physician Assistant 2800 N Vancouver Ave Ste 130, Portland, OR 97227 2019-07-01
1851955975 Erin Marie Staples Student in an Organized Health Care Education/Training Program 2800 N. Vancouver Ave;, Suite 230, Portland, OR 97227 2019-04-24
1922588508 Melanie Grace Mix Physician Assistant 501 N Graham St Ste 420, Portland, OR 97227 2018-08-14
1730615071 Mehran Giblin Student in an Organized Health Care Education/Training Program 2800 N. Vancouver Ave, Suite 230, Legacy Clinic Emanuel, Portland, OR 97227 2017-05-05
1730623687 Christina Grace Belter Optometrist 300 N Graham St Ste 300, Portland, OR 97227 2016-12-12
1407300205 Jenna Abernathy Counselor 3537 N Williams Ave, Portland, OR 97227 2016-08-09
1215390760 Tanya Marie Woods Massage Therapist 3808 N. Williams Ave., Portland, OR 97227 2016-04-01
1033596853 Eric Allen Martin Counselor 2054 N. Vancouver Ave, Portland, OR 97227 2015-04-30
1285040436 Berk Neurosurgical LLC Neurological Surgery 501 N Graham St Ste 500, Portland, OR 97227 2014-07-09
Find all providers in zip 97227

Taxonomy Information

Taxonomy Code 213ES0103X
Grouping Podiatric Medicine & Surgery Service Providers
Classification Podiatrist
Specialization Foot & Ankle Surgery

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1386051803 Southwest Podiatry Center LLC Podiatrist 9370 Sw Greenburg Rd Ste 102, Portland, OR 97223-5428 2014-07-16
1386884237 Lopa Dalmia Podiatrist 12400 Nw Cornell Rd Ste 201, Portland, OR 97229-5689 2009-03-04
1679743876 Brandi S. Myers Dpm, LLC Podiatrist 7836 Se 13th Ave, Portland, OR 97202-6350 2008-03-04
1093921975 Brian M. Bowen Podiatrist 1717 Ne 42nd Ave, Suite 3300, Portland, OR 97213-1569 2007-05-15
1689700486 Brandi Sue Myers Podiatrist 5225 Se 28th Ave, Portland, OR 97202-4506 2007-02-26
1255440020 Gina M Bullock Podiatrist 3508 Ne Broadway St, Portland, OR 97232-1821 2006-08-29
1982647467 Thomas R Palmer Podiatrist 6108 Ne Glisan St, Portland, OR 97213-3864 2006-06-13
1962454934 Clifford Donald Mah Podiatrist 12400 Nw Cornell Rd, Suite 201, Portland, OR 97229-5693 2006-05-17
1538149471 Christopher Gerard Pingitore Podiatrist 51 Sewall St Ste 2, Portland, ME 04102-2644 2006-01-18
1194705038 John Henry Dorsey Jr. Podiatrist 195 Fore River Parkway, Suite 120, Portland, ME 04102 2006-01-18
Find all providers in PORTLAND

Competitor

Search similar providers

City PORTLAND
Zip Code 97227

Improve Information

Please comment or provide details below to improve the information on JUSTIN ALAN TIDWELL.

Dataset Information

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.

Trending Searches