Individual
MS. ASHLEY B TIDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14344 SE BRIDGETON ST, CLACKAMAS, OR 97015-6265
(503) 806-6966
Mailing address
PO BOX 2586, CLACKAMAS, OR 97015-2586
(503) 806-6966
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
03/01/2021
Last updated
03/01/2021
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