Individual
MIKEL MATTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2214 LLOYD CTR, PORTLAND, OR 97232-1311
(503) 494-4222
(503) 494-6143
Mailing address
1400 SW 5TH AVE STE 500, PORTLAND, OR 97201-5537
(866) 617-6855
(503) 346-8015
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
207172
OR
2084P0800X
Psychiatry Physician
61207081
WA
2084P0800X
Psychiatry Physician
A122499
CA
Other
Enumeration date
04/29/2011
Last updated
10/25/2022
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