Individual
MOLLY ANNE MATTHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
2900 STATE ST, MEDFORD, OR 97504-8458
(541) 789-5790
(541) 789-5973
Mailing address
2825 E BARNETT RD # MSS, MEDFORD, OR 97504-8332
(541) 789-4281
(541) 789-4806
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
PA0003834
CO
363AM0700X
Medical Physician Assistant
Primary
PA205662
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA0003834
COLORADO LICENSE
CO
01
—
PA205662
OREGON MEDICAL BOARD
OR
Enumeration date
11/08/2013
Last updated
08/02/2021
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