Cheryl C. Tidball Do PC

NPI #1578776670 in Gresham, Oregon

Provider Information

NPI Number: 1578776670
Entity Type: Organization
Organization Name: Cheryl C. Tidball Do PC
Primary Specialty: General Practice
Enumeration Date: May 7, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 1217 NE BURNSIDE RD
Address 2: SUITE 101
City: Gresham
State: Oregon
ZIP Code: 97030-6722
Phone: (503) 489-0663

Authorized Official

Name: DR. CHERYL C. TIDBALL, D.O.
Title: PHYSICIAN
Phone: (503) 489-0663

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
General Practice	208D00000X	Primary

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