Active NPI
Emily Holly Mattson, LMP
- Specialist
- Vancouver, WA
National Provider Identifier
1679747869
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MA00006419
- Practice address
- 210 E McLoughlin Blvd
Vancouver, WA 98663-3369 - Phone
- (360) 693-3400
- NPI assigned
- Apr 17, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MA00006419 | WA | Primary |
Addresses
Primary practice location
210 E McLoughlin Blvd
Vancouver, WA 98663-3369
Mailing address
14968 Emerson CT
Oregon City, OR 97045-7571
Phone (503) 969-6342
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA00006419 | WA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208390400000",
"number": "1679747869",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14968 EMERSON CT",
"city": "OREGON CITY",
"state": "OR",
"postal_code": "970457571",
"telephone_number": "503-969-6342"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 E MCLOUGHLIN BLVD",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986633369",
"telephone_number": "360-693-3400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTSON",
"first_name": "EMILY",
"middle_name": "HOLLY",
"credential": "LMP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-04-17",
"last_updated": "2008-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "WA",
"license": "MA00006419",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.