Provider Demographics
NPI:1982810032
Name:WILKEN, MATTHEW A (AUD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:A
Last Name:WILKEN
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 UNION BLVD STE 124
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-1239
Mailing Address - Country:US
Mailing Address - Phone:303-233-3142
Mailing Address - Fax:303-233-3719
Practice Address - Street 1:445 UNION BLVD STE 124
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-1239
Practice Address - Country:US
Practice Address - Phone:303-233-3142
Practice Address - Fax:303-233-3719
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO256231H00000X
COAUD256231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO288795YR4SMedicare PIN
COCO304933Medicare PIN