Provider Demographics
NPI:1386121069
Name:HEBERLING, MATTHEW JOSEPH
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:JOSEPH
Last Name:HEBERLING
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4509 S 6TH ST STE 301
Mailing Address - Street 2:
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97603-4883
Mailing Address - Country:US
Mailing Address - Phone:541-238-6432
Mailing Address - Fax:541-230-7190
Practice Address - Street 1:4509 S 6TH ST STE 301
Practice Address - Street 2:
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97603-4883
Practice Address - Country:US
Practice Address - Phone:541-238-6432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-25
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPA190114363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant