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NPI Code Detail

MEDICARE: DAVID MATTIOLI RN

MEDICARE: DAVID MATTIOLI RN
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
1163WP0808XPsychiatric/Mental Health Registered NurseRN61389879WA
2251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1265954135
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID MATTIOLI RN
Provider Business Mailing Address
First Line : 7700 300TH ST NW
Second Line :
City : STANWOOD
State : WA
Zip : 98292-5841
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7700 300TH ST NW
Second Line :
City : STANWOOD
State : WA
Zip : 98292-5841
Country : US
Telephone Number : 360-209-8430
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2017
Last Update Date : 09/16/2025

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