Mattison, Gennaya Lynn

Mattison, Gennaya Lynn is an sole proprietor health care provider with primary practice located at 350 Miller St Se Ste 200 , Salem OR 97302-4272. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery, Allopathic & Osteopathic Physicians / Plastic Surgery. Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery is her primary health care specialty. Mattison, Gennaya Lynn can be contacted via phone (503) 400-3434.

Contact Information

Primary practice address
350 Miller St Se Ste 200 Salem OR 97302-4272
Phone: (503) 400-3434
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery 2086S0122X 198745 Oregon
Allopathic & Osteopathic Physicians / Plastic Surgery 208200000X 198745 Oregon

Profile Details

NPI number 1407266455
LBN Legal business name Mattison, Gennaya Lynn
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 29th, 2014
Last updated May 10th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407266455 NPPES
Oregon Other 198745 MEDICAL LICENSE

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