Individual
MR. MATTHEW VINSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW, LCSW, CADC III
Contact information
Practice address
1009 NW SPRUCE AVE, REDMOND, OR 97756-1212
(541) 891-9841
Mailing address
1009 NW SPRUCE AVE, REDMOND, OR 97756-1212
(541) 891-9841
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
16-05-19
OR
1041C0700X
Clinical Social Worker
Primary
7785
OR
1041C0700X
Clinical Social Worker
L7785
OR
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500657181
—
OR
05
—
500714484
—
OR
Enumeration date
01/26/2012
Last updated
08/11/2019
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