Individual
MICHAEL L MATLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3525 ENSIGN RD NE, SUITE 02, OLYMPIA, WA 98506-5065
(360) 459-1213
(360) 459-0114
Mailing address
3525 ENSIGN RD NE, SUITE 02, OLYMPIA, WA 98506-5065
(360) 459-1213
(360) 459-0114
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
16540
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1904101
—
WA
Enumeration date
11/17/2006
Last updated
04/02/2008
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