Healthcare Provider Details

I. General information

NPI: 1396254272
Provider Name (Legal Business Name): MATTHEW STEPHEN ST.CLAIR MS, LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2017
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

658 SE BAYSHORE DR
OAK HARBOR WA
98277-5700
US

IV. Provider business mailing address

316 SE PIONEER WAY # 1008
OAK HARBOR WA
98277-5716
US

V. Phone/Fax

Practice location:
  • Phone: 206-609-2642
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number60780224
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: