Healthcare Provider Details

I. General information

NPI: 1922936384
Provider Name (Legal Business Name): MATTHEW KEVIN VOSSEN JR. HAS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3857 WOLVERINE ST NE STE 16C
SALEM OR
97305-4270
US

IV. Provider business mailing address

3857 WOLVERINE ST NE STE 16C
SALEM OR
97305-4270
US

V. Phone/Fax

Practice location:
  • Phone: 503-588-1039
  • Fax: 503-588-1468
Mailing address:
  • Phone: 503-588-1039
  • Fax: 503-588-1468

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberHAS-P-10265349
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: