Healthcare Provider Details

I. General information

NPI: 1245164854
Provider Name (Legal Business Name): CEDAR TIDE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6607 NE 66TH AVE
VANCOUVER WA
98661-1520
US

IV. Provider business mailing address

6607 NE 66TH AVE
VANCOUVER WA
98661-1520
US

V. Phone/Fax

Practice location:
  • Phone: 503-547-5344
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: MIRANDA BELSHER
Title or Position: OWNER/CEO
Credential: BCBA
Phone: 503-547-5344