Individual
MATTHEW THOMAS PIVOVAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1046 6TH AVE SW, ALBANY, OR 97321-1916
(541) 812-4000
Mailing address
PO BOX 1189, CORVALLIS, OR 97339-1189
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1102211
TX
363A00000X
Physician Assistant
Primary
PA181331
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1102211
NCCPA ID #
—
Enumeration date
01/30/2012
Last updated
12/08/2025
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