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General NPI Number Information
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NPI Number | 1982862538
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Entity Type | Individual
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Provider Name | JOSHUA THOMAS MATSON PA
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Gender | Male
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Dates
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Enumeration Date | 05/30/2008
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Last Update Date | 10/30/2019
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Provider Practice Location Address
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Address Line | 550 E WASHINGTON BLVD STE 100
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City | CRESCENT CITY
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State | CA
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Zip | 95531
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Country | US
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Telephone | 707-465-6925
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Fax | 707-465-6070
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Provider Business Mailing Address
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Address Line | 670 9TH ST STE 203
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City | ARCATA
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State | CA
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Zip | 95521-6249
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Country | US
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Telephone | 707-826-8633
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Fax | 707-826-8633
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 3815
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 55780
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License Number State | CA
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