Paige Tiedeman, TLLP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301018372 Issued in MI

Practice address

1411 SW Morrison St Ste 310
Portland, OR 97205-1945

Phone

(503) 352-2400

NPI assigned

Feb 26, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1582675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701129600000",
    "number": "1992339253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 SW MORRISON ST STE 310",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972051945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 SW MORRISON ST STE 310",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972051945",
            "telephone_number": "503-352-2400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "595 Forest Ave",
            "address_purpose": "LOCATION",
            "city": "Plymouth",
            "state": "MI",
            "postal_code": "481701775",
            "country_code": "US",
            "telephone_number": "734-446-5466",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIEDEMAN",
        "first_name": "PAIGE",
        "credential": "TLLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-26",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301018372",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6361007588",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cathy Jean Tidland
• Brandy Lee Tidwell, PHD
• Justin Alan Tidwell, DPM
• Khalia Tidwell
• Monica Mary Tidwell, RN
• Julia Tienson, MSW
• Danielle Djoumbi Tientcheu, M.D.
• Carrie Tierney
• Mike Tierney, CADC II
• Rhonda C Tierney, M.D.

• Clinical Psychologist in Portland, OR
• Providers in Portland, OR by specialty
• Clinical Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2023; 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.