Individual
MATTHEW DEAN FIREBAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2500 NE NEFF RD, BEND, OR 97701-6015
(541) 706-5800
(541) 706-2645
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 543-6420
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA60321921
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1598019747
—
WA
Enumeration date
11/08/2012
Last updated
11/22/2021
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