Individual
NICHOLAI LEON MATHEWSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA, MSN
Contact information
Practice address
1015 NW 22ND AVE, PORTLAND, OR 97210-3025
(541) 601-0927
Mailing address
412 VERONA AVE, DANVILLE, CA 94526-2412
(541) 601-0927
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
95141062
CA
Other
Enumeration date
12/05/2019
Last updated
12/05/2019
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