Individual provider · Type 1 NPI

Kelsi Tidball

Specialist · Eugene, OR

NPI number 1093121014 Active

Practice location

1310 Coburg Rd Ste 5
Eugene, OR 97401-5200

Call (541) 345-7532 Map

Fax (541) 345-6692

Specialties and licenses

TaxonomyCodeLicense
Specialist Primary 174400000X16665 (OR)

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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About NPI 1093121014

Kelsi Tidball's National Provider Identifier is 1093121014, issued on Jul 10, 2014. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Eugene, OR. The record was last updated on Jul 10, 2014.