Provider Demographics
NPI:1962988485
Name:HILTON, MATHEW JOHN
Entity type:Individual
Prefix:
First Name:MATHEW
Middle Name:JOHN
Last Name:HILTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13432 WEYMOUTH ST
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-1746
Mailing Address - Country:US
Mailing Address - Phone:714-585-6050
Mailing Address - Fax:
Practice Address - Street 1:1250 NE 145TH ST
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98155-7134
Practice Address - Country:US
Practice Address - Phone:206-363-5856
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-17
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60842320225100000X
WV003895225100000X
TX1300718225100000X
KY007332225100000X
CA294731225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist