Provider Demographics
NPI:1467526277
Name:WALDRON, MATTHEW KEVIN (MATTHEW WALDRON DC)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:KEVIN
Last Name:WALDRON
Suffix:
Gender:M
Credentials:MATTHEW WALDRON DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23009 56TH AVE W STE B
Mailing Address - Street 2:
Mailing Address - City:MOUNTLAKE TERRACE
Mailing Address - State:WA
Mailing Address - Zip Code:98043-4713
Mailing Address - Country:US
Mailing Address - Phone:425-772-2700
Mailing Address - Fax:425-332-7018
Practice Address - Street 1:22933 HIGHWAY 99
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-8468
Practice Address - Country:US
Practice Address - Phone:425-772-2700
Practice Address - Fax:425-775-7842
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00003315111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor