Provider Demographics
NPI:1023907359
Name:FETH, MATTHEW (CSWA)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:FETH
Suffix:
Gender:M
Credentials:CSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 C ST APT 209
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:OR
Mailing Address - Zip Code:97351-2063
Mailing Address - Country:US
Mailing Address - Phone:406-558-9382
Mailing Address - Fax:
Practice Address - Street 1:675 ORCHARD HEIGHTS RD NW
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97304-3186
Practice Address - Country:US
Practice Address - Phone:406-558-9382
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-01
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health