KELSI TIDBALL NPI 1093121014

NPI Information

  • NPI: 1093121014
  • Provider Name: KELSI TIDBALL
  • Classification: Specialist - 174400000X
  • Entity Type: Individual
  • Address: 1310 COBURG RD STE 5
    EUGENE, OR
    ZIP 97401
  • Phone: (541) 345-7532

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NPI Details

Kelsi Tidball is a specialist in Eugene, OR. The provider is 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. Kelsi Tidball NPI is 1093121014. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1310 COBURG RD STE 5
EUGENE, OR
ZIP 97401-200
Phone: (541) 345-7532
Fax: (541) 345-6692

The enumeration date for this NPI number is 7/10/2014 and was last updated on 7/10/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialist16665OREGONYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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