Provider Demographics
NPI:1699770305
Name:LAYTON, MATTHEW (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:
Last Name:LAYTON
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 W COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-2010
Mailing Address - Country:US
Mailing Address - Phone:509-324-1420
Mailing Address - Fax:509-324-3622
Practice Address - Street 1:1101 W COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-2010
Practice Address - Country:US
Practice Address - Phone:509-324-1420
Practice Address - Fax:509-324-3622
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-17
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000330942084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8211021Medicaid
G44310Medicare UPIN
WAAB10920Medicare ID - Type Unspecified