Individual
ROBERT MICHAEL MATTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9720 S TACOMA WAY, LAKEWOOD, WA 98499-4456
(253) 604-7422
(253) 302-8493
Mailing address
PO BOX 39680, LAKEWOOD, WA 98496-3680
(253) 604-7422
(253) 302-8493
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP61584281
WA
Other
Enumeration date
05/20/2025
Last updated
05/20/2025
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