Provider Demographics
NPI:1285284299
Name:BROWN, MATTHEW (ND)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:BROWN
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 NE LINDEN AVE STE 5
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97030-3956
Mailing Address - Country:US
Mailing Address - Phone:503-925-6605
Mailing Address - Fax:
Practice Address - Street 1:1300 NE LINDEN AVE STE 5
Practice Address - Street 2:
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97030-3956
Practice Address - Country:US
Practice Address - Phone:503-925-6605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-12
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4263175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath