Provider Demographics
NPI:1447769070
Name:SEIDERS, TIFFANY ELLEN (CPM, LDM)
Entity Type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:ELLEN
Last Name:SEIDERS
Suffix:
Gender:F
Credentials:CPM, LDM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3017 NW 8TH ST
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:OR
Mailing Address - Zip Code:97756-1230
Mailing Address - Country:US
Mailing Address - Phone:541-728-1416
Mailing Address - Fax:541-516-8996
Practice Address - Street 1:3017 NW 8TH ST
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:OR
Practice Address - Zip Code:97756-1230
Practice Address - Country:US
Practice Address - Phone:541-728-1416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDEMLD10186337176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife