Individual
JESSICA MATOUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4421 NE ST JOHNS RD STE F, VANCOUVER, WA 98661-2573
(360) 699-6374
Mailing address
1921 SE 124TH CT, VANCOUVER, WA 98683-3849
(360) 597-5814
Taxonomy
Speciality
Code
Description
License number
State
2081P0010X
Pediatric Rehabilitation Medicine Physician
Primary
PT00007039
WA
Other
Enumeration date
03/03/2007
Last updated
03/04/2024
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