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Individual

MATTHEW KAI ELLIOTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
840 E HILL AVE, MOSES LAKE, WA 98837-2238
(509) 663-8711
Mailing address
840 E HILL AVE, MOSES LAKE, WA 98837-2238
(509) 663-8711

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
OP60455629
WA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1902046162
WA
01
P01374511
RR MEDICARE
WA
Enumeration date
03/01/2009
Last updated
06/15/2022
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