Taylor, Matthew S

Taylor, Matthew S is an individual health care provider with primary practice located at 620 Ne 2Nd St , Gresham OR 97030-7514. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Social Worker. Behavioral Health & Social Service Providers / Social Worker is his primary health care specialty. Taylor, Matthew S can be contacted via phone (971) 274-3757.

Contact Information

Primary practice address
620 Ne 2Nd St Gresham OR 97030-7514
Phone: (971) 274-3757
Fax: (503) 912-5740
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X Oregon
Behavioral Health & Social Service Providers / Social Worker 104100000X A4886 Oregon

Profile Details

NPI number 1164805412
LBN Legal business name Taylor, Matthew S
Credentials CSWA/QMHP
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 6th, 2015
Last updated Jun 1st, 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 1164805412 NPPES
Oregon MEDICAID 500689886

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