Individual
HARRIET JEAN MATTLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1322 E MCANDREWS RD STE 202, MEDFORD, OR 97504-6177
(541) 773-3688
(541) 773-3125
Mailing address
1322 E MCANDREWS RD SUITE 202, MEDFORD, OR 97504
(541) 773-3688
(541) 773-3125
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
15398
CA
363L00000X
Nurse Practitioner
201400209RN
OR
363LF0000X
Family Nurse Practitioner
15398
CA
363LF0000X
Family Nurse Practitioner
Primary
201400210NP-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201400210NP-PP
OREGON LICENSE
OR
01
—
38-3990
MEDICARE PART A
OR
01
—
930937095
CURRY HEALTH DISTRICT
OR
01
—
NP 15398
NP LICENSE
CA
01
—
R0000ZGBDG
CURRY GENERAL HOSPITAL MEDICARE PART B
OR
01
—
RN 389101
RN LICENSE
CA
Enumeration date
11/23/2009
Last updated
03/07/2023
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