Individual
MATTHEW SPRAGUE KIDDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7330 SE 42ND AVE, PORTLAND, OR 97206-8404
(503) 358-2891
Mailing address
7330 SE 42ND AVE, PORTLAND, OR 97206-8404
(503) 358-2891
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
07/06/2018
Last updated
01/26/2024
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