Individual
TIMOTHY MATIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10315 NE TANASBOURNE DR, HILLSBORO, OR 97124-7836
(503) 286-6868
Mailing address
1095 SW 197TH AVE, ALOHA, OR 97003-2470
(503) 720-2831
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H7315
OR
Other
Enumeration date
10/08/2019
Last updated
10/08/2019
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