Individual
MATT CHILDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1315 11TH CT SW, NORTH BEND, WA 98045-7989
(812) 251-6639
Mailing address
1315 11TH CT SW, NORTH BEND, WA 98045-7989
(812) 251-6639
Taxonomy
Speciality
Code
Description
License number
State
251X00000X
Supports Brokerage Agency
Primary
1031895
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1031895
INSURANCE LICENSE NUMBER
WA
01
—
19306485
NATIONAL PRODUCER NUMBER
—
Enumeration date
01/08/2021
Last updated
01/08/2021
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