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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

JUSTIN ALAN TIDWELL, DPM

Active Sole Proprietor

JUSTIN ALAN TIDWELL, DPM is a Foot & Ankle Surgery Podiatrist healthcare provider located in PORTLAND, Oregon. NPI 1710908892 is currently active in the NPPES registry. Verify at CMS.

Foot & Ankle Surgery Podiatrist · PORTLAND, OR

Registration Details

NPI Number
1710908892
Provider Type
Individual
Gender
Male
NPI Issued
Jul 22, 2006 (20.021963709953 yrs)
Last Updated
Jul 8, 2007
Licenses
PO00000806 (WA)
DP00373 (OR)
Sole Proprietor
Yes

Practice Information

Address
501 N GRAHAM ST
SUITE 415
PORTLAND, OR, 972271654
Browse OR providers · Browse ZIP 97227
Phone
5034132005
Fax
5034133699
Primary Specialty
Foot & Ankle Surgery Podiatrist
213ES0103X

Other Foot & Ankle Surgery Podiatrist Providers in PORTLAND, OR

Name Credential NPI
PAUL CLINT JONES D.P.M. 1174519359
CLIFFORD DONALD MAH D.P.M. 1962454934
THOMAS R PALMER DPM 1982647467
DR. JARED KEITH REMMERS D.P.M. 1932112463
DR. ERIC DAVID EVANS D.P.M 1700899051
THOMAS CHARLES MELILLO DPM 1619085479
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.