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NPI Code Detail

MEDICARE: MATTHEW J WATSON DO

MEDICARE: MATTHEW J WATSON DO
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
1208800000XUrology PhysicianOP61546556WA
2208800000XUrology Physician70820MN
3208800000XUrology Physician60GA

General Provider Information

NPI Number : 1275066441
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW J WATSON DO
Provider Business Mailing Address
First Line : PO BOX 3360
Second Line :
City : PORTLAND
State : OR
Zip : 97208-3360
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 21822 76TH AVE W
Second Line :
City : EDMONDS
State : WA
Zip : 98026-7900
Country : US
Telephone Number : 425-775-7166
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2017
Last Update Date : 01/14/2026

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