JUSTIN ALAN TIDWELL, DPM
Medical Practice at Graham St, Portland, OR

License number
Oregon PO00000806
Category
Medical Practice
Type
Foot & Ankle Surgery
License number
Oregon DP00373
Category
Medical Practice
Type
Foot & Ankle Surgery
Address
Address
501 N Graham St SUITE 415, Portland, OR 97227
Phone
(503) 413-2005
(503) 413-3699 (Fax)
(503) 936-7454
National Provider ID: 1710908892
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Personal information

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Name
Address
Phone
Justin Tidwell
5815 NE 23Rd Ave, Portland, OR 97211
Justin Tidwell
2222 Lovejoy St, Portland, OR 97210

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