Cheryl C. Tidball Do Pc

LBN: Cheryl C. Tidball Do Pc
Cheryl C. Tidball Do Pc is an health care organization with primary practice located at 1217 Ne Burnside Rd Suite 101, Gresham OR 97030-6722. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as the primary health care specialty. Cheryl C. Tidball Do Pc can be contacted via phone (503) 489-0663, or through Tidball, Cheryl C. via phone (503) 489-0663.

Contact Information

Primary practice address
1217 Ne Burnside Rd Suite 101 Gresham OR 97030-6722
Phone: (503) 489-0663
Fax: (503) 666-5644
Website:
Map and Directions
Authorized official contact:
Name: Tidball, Cheryl C. Doctor of Osteopathy (DO)
Phone: (503) 489-0663

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X DO19432 Oregon

Profile Details

NPI number 1578776670
LBN Legal business name Cheryl C. Tidball Do Pc
DBA Doing business as
Authorized official Tidball, Cheryl C. Doctor of Osteopathy (DO)
Entity Organization
Organization subpart 1 No
Enumeration date May 7th, 2007
Last updated Aug 22nd, 2020 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578776670 NPPES
Oregon MEDICAID 203778

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