Provider Demographics
NPI:1225326689
Name:MATRIX MEDICAL NETWORK OF WASHINGTON, L.L.C.
Entity Type:Organization
Organization Name:MATRIX MEDICAL NETWORK OF WASHINGTON, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-862-1695
Mailing Address - Street 1:9201 E MOUNTAIN VIEW RD STE 220
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-5172
Mailing Address - Country:US
Mailing Address - Phone:480-862-1677
Mailing Address - Fax:480-907-2108
Practice Address - Street 1:506 2ND AVE STE 1400
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2329
Practice Address - Country:US
Practice Address - Phone:808-621-6774
Practice Address - Fax:480-718-7643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-19
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty