Individual
CATHY JEAN TIDLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2330 NE SISKIYOU ST, PORTLAND, OR 97212-2471
(503) 528-0757
(503) 528-0764
Mailing address
2330 NE SISKIYOU ST, PORTLAND, OR 97212-2471
(503) 528-0757
(503) 528-0764
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
372600000X
Adult Companion
—
—
Other
Enumeration date
05/14/2007
Last updated
04/09/2008
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