Individual
JOSE MATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
14841 179TH AVE SE STE 210, MONROE, WA 98272-1127
(360) 217-1155
(360) 217-1154
Mailing address
14841 179TH AVE SE STE 210, MONROE, WA 98272-1127
(360) 217-1155
(360) 217-1154
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00046741
WA
Other
Enumeration date
12/22/2005
Last updated
11/17/2025
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