Individual
MATTHEW CHARLES MCCLELLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
18040 SW LOWER BOONES FERRY RD, SUITE 100, TIGARD, OR 97224-7258
(503) 216-0700
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD28188
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
218648
—
OR
01
—
P00981639
RR MEDICARE
OR
Enumeration date
01/22/2007
Last updated
12/14/2021
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