Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Ryan Christian Jennings-Tidwell

Individual provider In Home Supportive Care Agency · NPI 1417622069

Ryan Christian Jennings-Tidwell is an In Home Supportive Care Agency in Troutdale, Oregon. Practices as a sole proprietor. Licensed in Oregon.

Licensed in
OR
In the registry since
2021
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Practice location Address checks out

1042 SE 30th Pl
Troutdale, OR 97060-9456
Phone: (503) 618-9668
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

In Home Supportive Care Agency (primary) Taxonomy 253Z00000X · Licence 854291 (OR)

Record details

NPI number1417622069
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedAugust 14, 2021
Last updated in NPPESAugust 14, 2021
Certification dateAugust 14, 2021

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