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NPI Code Detail

MEDICARE: DR. MATTHEW DAVID VAN AUKEN M.D., M.P.H.

MEDICARE: DR. MATTHEW DAVID VAN AUKEN M.D., M.P.H.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1202D00000XIntegrative Medicine PhysicianMD60656729WA
2202D00000XIntegrative Medicine PhysicianMD206943OR
3207Q00000XFamily Medicine PhysicianPG177252OR
4207Q00000XFamily Medicine PhysicianMD206943OR
5207Q00000XFamily Medicine PhysicianMD60656729WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MD206943OTHEROROREGON STATE
2MD60656729OTHERWAWASHINGTON STATE

General Provider Information

NPI Number : 1528474806
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MATTHEW DAVID VAN AUKEN M.D., M.P.H.
Provider Business Mailing Address
First Line : 3310 SE OAK ST
Second Line :
City : PORTLAND
State : OR
Zip : 97214-2061
Country : US
Telephone Number : 732-995-9369
Fax Number :
Provider Business Practice Location Address
First Line : 5220 NE HAZEL DELL AVE
Second Line :
City : VANCOUVER
State : WA
Zip : 98663-1242
Country : US
Telephone Number : 360-693-1474
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2014
Last Update Date : 03/25/2023

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