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NPI Code Detail

MEDICARE: MATTHEW SCOTT PATTEN MS

MEDICARE: MATTHEW SCOTT PATTEN MS
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
1101YM0800XMental Health CounselorLH00003903WA

General Provider Information

NPI Number : 1639227317
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW SCOTT PATTEN MS
Provider Business Mailing Address
First Line : 2428 W REYNOLDS AVE
Second Line :
City : CENTRALIA
State : WA
Zip : 98531-4554
Country : US
Telephone Number : 360-330-9044
Fax Number :
Provider Business Practice Location Address
First Line : 2428 W REYNOLDS AVE
Second Line :
City : CENTRALIA
State : WA
Zip : 98531-4554
Country : US
Telephone Number : 360-330-9044
Fax Number : 360-736-3139
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/08/2007
Last Update Date : 03/08/2017

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