MEDICARE: RACHEL M MATTERN PA-C

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
1	363A00000X	Physician Assistant	PA100004734	WA
2	363A00000X	Physician Assistant	500	MT

Other Identifiers

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

General Provider Information

NPI Number	:	1275539884
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL M MATTERN PA-C

Provider Business Mailing Address
First Line	:	PO BOX 6369
Second Line	:
City	:	HELENA
State	:	MT
Zip	:	59604-6369
Country	:	US
Telephone Number	:	406-447-2823
Fax Number	:

Provider Business Practice Location Address
First Line	:	2707 COLONIAL DR
Second Line	:
City	:	HELENA
State	:	MT
Zip	:	59601-4926
Country	:	US
Telephone Number	:	406-457-0800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2005
Last Update Date	:	10/09/2015

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