IndividualActive
Andrew Tistadt, PA-C
NPI 1831269265 · Medical Physician Assistant · West Linn, OR
Provider details
- NPI number
- 1831269265
- Entity type
- Individual
- Primary specialty
- Medical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- License
- PA01174 (OR)
Practice location
21810 Willamette Dr Ste 200
West Linn, OR 97068-3287
Phone: (503) 994-4353
Fax: (503) 722-5100
Mailing address
21810 Willamette Dr Ste 200
West Linn, OR 97068-3287
Registry dates
- Enumerated
- 2006-11-09
- Last updated
- 2026-03-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.