Individual
MR. MAT F. NYQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS LPC
Contact information
Practice address
388 STATE ST # 710, SALEM, OR 97301
(503) 507-5961
(503) 339-1972
Mailing address
2176 CHILDS AVE NE, SALEM, OR 97301-7471
(503) 507-5961
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
C 3826
OR
Other
Enumeration date
01/29/2009
Last updated
08/25/2015
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