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General NPI Number Information
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NPI Number | 1508972159
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Entity Type | Individual
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Provider Name | KERRY ANNE MATTHEWS MD
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Gender | Female
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 03/13/2026
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Provider Practice Location Address
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Address Line | 203 SE PARK PLAZA DR STE 140
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City | VANCOUVER
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State | WA
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Zip | 98684-5887
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Country | US
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Telephone | 800-813-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 500 NE MULTNOMAH ST STE 100
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City | PORTLAND
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State | OR
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Zip | 97232-2099
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Country | US
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Telephone | 800-813-2000
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD18727
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD00032004
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License Number State | WA
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