Individual
GREGORY SCOTT SIDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4301 S PINE ST STE 301, TACOMA, WA 98409-7206
(253) 476-6500
(253) 476-6547
Mailing address
4301 S PINE ST STE 301, TACOMA, WA 98409-7206
(253) 476-6500
(253) 476-6547
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
01052695A
IN
2084P0800X
Psychiatry Physician
Primary
MD61058340
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200303280A
—
IN
Enumeration date
07/19/2006
Last updated
05/05/2021
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