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NPI Code Detail

MEDICARE: ROGER W MATTISON M.S.

MEDICARE: ROGER W MATTISON M.S.
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
1231H00000XAudiologistAU 301CA
2237600000XAudiologist-Hearing Aid FitterHA 954CA

General Provider Information

NPI Number : 1598863680
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROGER W MATTISON M.S.
Provider Business Mailing Address
First Line : 3770 JANES RD
Second Line :
City : ARCATA
State : CA
Zip : 95521-4744
Country : US
Telephone Number : 707-822-9122
Fax Number : 707-822-1969
Provider Business Practice Location Address
First Line : 3770 JANES RD
Second Line :
City : ARCATA
State : CA
Zip : 95521-4744
Country : US
Telephone Number : 707-822-9122
Fax Number : 707-822-1969
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2006
Last Update Date : 09/11/2025

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Directions to “ ROGER W MATTISON M.S.” Practice Location

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