Provider Demographics
NPI:1063445401
Name:HALSEY, MATTHEW F (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:F
Last Name:HALSEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3181 SW SAM JACKSON PARK RD
Mailing Address - Street 2:DEPARTMENT OF ORTHOPAEDICS, OP-31
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-3011
Mailing Address - Country:US
Mailing Address - Phone:503-494-6400
Mailing Address - Fax:503-494-5050
Practice Address - Street 1:3181 SW SAM JACKSON PARK RD
Practice Address - Street 2:DEPARTMENT OF ORTHOPAEDICS, OP-31
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-3011
Practice Address - Country:US
Practice Address - Phone:503-494-6400
Practice Address - Fax:503-494-5050
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA75955207XP3100X
ORMD28574207XP3100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0085690Medicaid
CA00A759550Medicaid
CAH56674Medicare UPIN