Matthew Joseph Bartolotti, LSCW

Individual provider Active NPI Clinical Social Worker · Gresham, OR

NPI 1013063643 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1013063643
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
L3716 (OR)
Practice address
400 NE 7TH St
Gresham, OR 97030-5604
Phone
(503) 489-2236
NPI assigned
Jan 26, 2007
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
L3716ORMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X L3716 OR Yes

Addresses

Primary practice location

400 NE 7TH St
Gresham, OR 97030-5604

Mailing address

5527 SE 54TH Ave
Portland, OR 97206-5659
Phone (503) 860-9406

Other providers in Gresham, OR

All providers in Gresham, OR · Clinical Social Worker in Oregon

Sources for this page

Verify at the official NPI Registry.