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General NPI Number Information
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NPI Number | 1245506237
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Entity Type | Individual
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Provider Name | MATTHEW JAMES FLYNN M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/24/2012
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Last Update Date | 05/18/2020
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Provider Practice Location Address
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Address Line | 12607 SE MILL PLAIN BLVD STE N713
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City | VANCOUVER
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State | WA
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Zip | 98684-6055
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Country | US
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Telephone | 360-449-1758
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Fax |
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Provider Business Mailing Address
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Address Line | 12607 SE MILL PLAIN BLVD
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City | VANCOUVER
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State | WA
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Zip | 98684-6055
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Country | US
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Telephone | 360-449-1758
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | MD60929341
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | MD192177
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | MD192177
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License Number State | OR
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Taxonomy #4
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | MD60929341
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License Number State | WA
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