| Doctor Name: | ROBERT JOHN TILLEY |
| NPI Number: | 1114044393 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 14698 |
| Business Practice Address: | 12720 Sw Pacific Hwy Ste 1 Tigard, OR - 972236125 |
| Business Phone Number: | 5039746170 |
| Business Fax Number: | 5032087198 |
| Mailing Address: | 12720 Sw Pacific Hwy #1, TIGARD |
| State: | OR |
| Postal Code: | 972236125 |
| Phone Number: | 5039746170 |
| Fax Number: | 5032087198 |
| NPI Enumeration Date: | 03/23/2007 |
| NPI Last Update Date: | 11/02/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 14698 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |