Healthcare Provider Details

I. General information

NPI: 1831009497
Provider Name (Legal Business Name): MATTHEW M SANTI CO61565659
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7510 W DESCHUTES PL
KENNEWICK WA
99336-7719
US

IV. Provider business mailing address

75 ELLIE ANN CT
PROSSER WA
99350-7824
US

V. Phone/Fax

Practice location:
  • Phone: 509-579-0738
  • Fax:
Mailing address:
  • Phone: 425-308-0353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCO61565659
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: