Healthcare Provider Details

I. General information

NPI: 1104245190
Provider Name (Legal Business Name): MATTHEW TIPPING M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2014
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94220 4TH ST
GOLD BEACH OR
97444-7772
US

IV. Provider business mailing address

3600 N INTERSTATE AVE
PORTLAND OR
97227-1106
US

V. Phone/Fax

Practice location:
  • Phone: 541-247-3000
  • Fax: 541-247-3109
Mailing address:
  • Phone: 503-331-6500
  • Fax: 503-331-6505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberMD182720
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: