Individual
ALLISON MARIE MATTILA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP
Contact information
Practice address
10 PIER 1 STE 301, ASTORIA, OR 97103-6338
(503) 741-3570
(503) 741-3569
Mailing address
10 PIER 1 STE 301, ASTORIA, OR 97103-6338
(503) 741-3570
(503) 741-3569
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
200750140NP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
231893
FQHC MEDICAID
OR
05
—
242060
—
OR
01
—
38-1852
FQHC MEDICARE
—
Enumeration date
10/10/2007
Last updated
07/07/2023
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