Individual provider Active NPI

Christine L Matthews, PA C

  • Surgical Physician Assistant
  • Longview, WA
National Provider Identifier
1629097621
Registry record updated Feb 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA10003202 Issued in WA
Practice address
625 9TH Ave Ste 210
Longview, WA 98632-2465
Phone
(360) 501-3400
Fax
(360) 423-6862
NPI assigned
Jul 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA10003202 WA
Surgical Physician Assistant 363AS0400X PA10003202 WA Primary

Addresses

Primary practice location

625 9TH Ave Ste 210
Longview, WA 98632-2465

Mailing address

625 9TH Ave Ste 210
Longview, WA 98632-2465
Phone (360) 501-3400

Other practice location 1

1718 E Kessler Blvd
Longview, WA 98632-1842
Phone (360) 747-5800

Other identifiers 4

IdentifierTypeStateIssuer
8414914MedicaidWA
0217051OtherWALABOR & IND.
MA7320OtherRAILROAD MEDICARE
8943478OtherWACRIME VICTIMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070315000329 WA Practitioner - Physician Assistant 2062440241 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PeacehealthGroup PAC ID 5890689293, 188 clinicians

Practice addresses (Care Compare)

1615 Delaware St
Longview, WA 98632-2367
Phone (360) 636-4814

1660 Delware St
Longview, WA 98632-2310
Phone (360) 414-2800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA10003202WAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth CurrentSince Mar 28, 2022 Accepting new patients
Peacehealth Past Accepting new patients
Longview Surgical Group Past Accepting new patients

Locations

1615 Delaware St
Longview, WA 98632
Phone (360) 363-4818

625 9th Ave
Ste 210
Longview, WA 98632
Phone (360) 501-3400

1718 E Kessler Blvd
Longview, WA 98632
Phone (360) 747-5800

1615 Delaware St
Ste 200
Longview, WA 98632
Phone (360) 501-3500

Interoperability endpoints

  • Direct secure messaging: cmatthews50690@direct.peacehealth.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643760000000",
    "number": "1629097621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 9TH AVE STE 210",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322465",
            "telephone_number": "360-501-3400",
            "fax_number": "360-423-6862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 9TH AVE STE 210",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322465",
            "telephone_number": "360-501-3400",
            "fax_number": "360-423-6862"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1718 E Kessler Blvd",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "WA",
            "postal_code": "986321842",
            "country_code": "US",
            "telephone_number": "360-747-5800",
            "fax_number": "360-575-3846",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATTHEWS",
        "first_name": "CHRISTINE",
        "middle_name": "L",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2022-02-02",
        "certification_date": "2022-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10003202",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA10003202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8414914",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & IND.",
            "identifier": "0217051",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "MA7320",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRIME VICTIMS",
            "identifier": "8943478",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, WA

Sources for this page

Verify at the official NPI Registry.