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Individual

OLIVIA MATTUS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CPC

Contact information

Practice address
748 14TH AVENUE, LONGVIEW, WA 98632
(360) 200-5419
(360) 200-6736
Mailing address
PO BOX 2394, LONGVIEW, WA 98632
(360) 200-5419
(360) 200-6736

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
175T00000X
Peer Specialist
Primary
60871230
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2104938
WA
Enumeration date
07/26/2018
Last updated
11/13/2020
About Stedi
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