MEDICARE: MATTHEW TOBECK

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1558299867
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW TOBECK

Provider Business Mailing Address
First Line	:	5644 SE KNIGHT ST
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97206-6024
Country	:	US
Telephone Number	:	612-701-2992
Fax Number	:

Provider Business Practice Location Address
First Line	:	5644 SE KNIGHT ST
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97206-6024
Country	:	US
Telephone Number	:	612-701-2992
Fax Number	:

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

Provider Enumeration Date	:	05/08/2026
Last Update Date	:	05/08/2026

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Directions to “ MATTHEW TOBECK ” Practice Location

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