Individual provider Active NPI

Robin Lynn Tiedeman, M.S.W.

  • Clinical Social Worker
  • Eugene, OR
National Provider Identifier
1629109004
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1790 W 11TH Ave Ste 290
Eugene, OR 97402-3759
Phone
(541) 686-1262
Fax
(541) 686-0359
NPI assigned
Mar 8, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

1790 W 11TH Ave Ste 290
Eugene, OR 97402-3759

Mailing address

34863 Seavey Loop Rd
Eugene, OR 97405-9620
Phone (541) 741-0417

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629109004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34863 SEAVEY LOOP RD",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974059620",
            "telephone_number": "541-741-0417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1790 W 11TH AVE STE 290",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974023759",
            "telephone_number": "541-686-1262",
            "fax_number": "541-686-0359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIEDEMAN",
        "first_name": "ROBIN",
        "middle_name": "LYNN",
        "credential": "M.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.