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General NPI Number Information
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NPI Number | 1588852537
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Entity Type | Individual
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Provider Name | HOLLY M. MATTHEWS MSW, LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/03/2007
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Last Update Date | 06/20/2016
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Provider Practice Location Address
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Address Line | 7409 SW CAPITOL HWY STE 201
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City | PORTLAND
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State | OR
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Zip | 97219-2432
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Country | US
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Telephone | 503-406-8064
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Fax | 503-245-1323
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Provider Business Mailing Address
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Address Line | 7237 SW 28TH AVE SUITE 400 PORTLAND TRAUMA RECOVERY
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City | PORTLAND
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State | OR
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Zip | 97219-2590
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Country | US
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Telephone | 503-333-0543
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Fax | 503-245-1323
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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 | 4291
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License Number State | OR
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