Provider Demographics
NPI:1508887647
Name:TIO-MATOS, IRIS MARIA (MD)
Entity Type:Individual
Prefix:
First Name:IRIS
Middle Name:MARIA
Last Name:TIO-MATOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9600 VETERANS DRIVE A-111-R
Mailing Address - Street 2:AMERICAN LAKE VA
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98493-0001
Mailing Address - Country:US
Mailing Address - Phone:253-582-8440
Mailing Address - Fax:253-589-4150
Practice Address - Street 1:PSHCS AMERICAN LAKE DIVISION
Practice Address - Street 2:A-111-PC
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98493-5000
Practice Address - Country:US
Practice Address - Phone:253-582-8440
Practice Address - Fax:253-589-4150
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA31306207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine