Healthcare Provider Details

I. General information

NPI: 1144499740
Provider Name (Legal Business Name): MATTHEW J. FLEISCHMAN, PHD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2008
Last Update Date: 02/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 OAK ST STE 300
EUGENE OR
97401-3142
US

IV. Provider business mailing address

915 OAK ST STE 300
EUGENE OR
97401-3142
US

V. Phone/Fax

Practice location:
  • Phone: 541-343-9221
  • Fax: 541-343-6410
Mailing address:
  • Phone: 541-343-9221
  • Fax: 541-343-6410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number496
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MATTHEW J. FLEISCHMAN
Title or Position: PRESIDENT
Credential: PHD, PC
Phone: 541-343-9221