Tidal Health NW

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Legal business name

TIDAL HEALTH NW

Practice address

5517 N Commercial Ave Ste D
Portland, OR 97217-2339

Phone

(720) 952-7019

Fax

(720) 815-0357

NPI assigned

Oct 21, 2026

Last updated

Oct 21, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kimberly Margaret Clifford, PA-CNPI 1386949295

Title

Owner, PA-C

Phone

(303) 668-6784

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kimberly M. Clifford, PA-C

  • Physician Assistant
  • Portland, OR
  • NPI 1386949295
  NPD (past) Authorized official

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

{
    "created_epoch": "1792540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1792540800000",
    "number": "1831096072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5517 N COMMERCIAL AVE STE D",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972172339",
            "telephone_number": "720-952-7019",
            "fax_number": "720-815-0357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5517 N COMMERCIAL AVE STE D",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972172339",
            "telephone_number": "720-952-7019",
            "fax_number": "720-815-0357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIDAL HEALTH NW",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-10-21",
        "last_updated": "2026-10-21",
        "certification_date": "2026-10-21",
        "status": "A",
        "authorized_official_last_name": "CLIFFORD",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "MARGARET",
        "authorized_official_title_or_position": "OWNER, PA-C",
        "authorized_official_telephone_number": "303-668-6784",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alheli Tica-Figueroa, MA
• Brittney Tice, RN BSN
• Emma Louise Tice
• Gracen Tichelaar
• Dana Ticker, B.A.
• Suzanne Gail Tiddy, LCSW
• Cathy Jean Tidland
• Brandy Lee Tidwell, PHD
• Justin Alan Tidwell, DPM
• Khalia Tidwell

• Physician Assistant in Portland, OR
• Providers in Portland, OR by specialty
• Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2026; 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.