Individual
KRISTIN MARIE MATHES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
296 SW COLUMBIA ST STE D2, BEND, OR 97702-1020
(920) 286-2316
Mailing address
1622 NW AWBREY RD, BEND, OR 97703-1833
(920) 286-2316
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
L10773
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500737558
—
OR
Enumeration date
12/13/2017
Last updated
10/26/2021
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