Individual
MATTHEW STEVEN DIETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8211
Mailing address
5150 SW LANDING, 105, PORTLAND, OR 97239-4414
(860) 841-7599
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
DO176689
OR
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
11767382-1204
UT
Other
Enumeration date
03/21/2013
Last updated
12/20/2021
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