| Cheryl C. Tidball Do Pc | |
|
1217 Ne Burnside Rd Suite 101 Gresham OR 97030-6722 | |
| (503) 489-0663 | |
| (503) 666-5644 |
| Full Name | Cheryl C. Tidball Do Pc |
|---|---|
| Speciality | General Practice |
| Location | 1217 Ne Burnside Rd, Gresham, Oregon |
| Authorized Official Name and Position | Cheryl C. Tidball (PHYSICIAN) |
| Authorized Official Contact | 5034890663 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cheryl C. Tidball Do Pc 1217 Ne Burnside Rd Suite 101 Gresham OR 97030-6722 Ph: (503) 489-0663 | Cheryl C. Tidball Do Pc 1217 Ne Burnside Rd Suite 101 Gresham OR 97030-6722 Ph: (503) 489-0663 |
| NPI Number | 1578776670 |
|---|---|
| Provider Enumeration Date | 05/07/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578776670 | NPI | - | NPPES |
| 203778 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | DO19432 (Oregon) | Primary |
Roberts Street Clinic, P.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 400 Ne Roberts Ave, Gresham, OR 97030 Phone: 503-669-3066 Fax: 503-665-6404 | |
Providence Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 440 Nw Division St, Gresham, OR 97030 Phone: 503-215-9500 Fax: 503-215-9525 | |
Gresham Women's Health Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 515 Ne Roberts Ave, Gresham, OR 97030 Phone: 503-477-2478 | |
Gresham Internal Medicine Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 24900 Se Stark St Ste 109, Gresham, OR 97030 Phone: 503-667-1015 Fax: 503-667-0406 | |
Mobile Vaccs Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3838 Se Saint Andrews Pl, Gresham, OR 97080 Phone: 503-858-7403 | |
Gresham Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 400 Ne 7th St, Gresham, OR 97030 Phone: 503-238-0769 Fax: 503-889-2599 | |
Legacy Mount Hood Medical Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 24800 Se Stark St, Gresham, OR 97030 Phone: 503-674-1122 |