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NPI Code Detail

MEDICARE: MATTHEW J BREEZE MD

MEDICARE: MATTHEW J BREEZE MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianMD26335OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083655609
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW J BREEZE MD
Provider Business Mailing Address
First Line : PO BOX 3158
Second Line :
City : PORTLAND
State : OR
Zip : 97208-3158
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4920 N INTERSTATE AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97217-3653
Country : US
Telephone Number : 503-215-3000
Fax Number : 503-215-3350
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2006
Last Update Date : 10/05/2020

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