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General NPI Number Information
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NPI Number | 1467761726
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Entity Type | Individual
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Provider Name | MATTHEW D LAUZON MSW, LCSW
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Gender | Male
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Dates
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Enumeration Date | 10/04/2010
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Last Update Date | 06/28/2024
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Provider Practice Location Address
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Address Line | 811 SW 6TH AVE STE 1000
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City | PORTLAND
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State | OR
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Zip | 97204-1345
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Country | US
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Telephone | 503-334-3035
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Fax | 503-961-9212
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Provider Business Mailing Address
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Address Line | 811 SW 6TH AVE STE 1000
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City | PORTLAND
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State | OR
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Zip | 97204-1345
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Country | US
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Telephone | 503-334-3035
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Fax | 503-961-9212
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 4622
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | L4622
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License Number State | OR
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