Provider Demographics
NPI:1588852537
Name:MATTHEWS, HOLLY M (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:HOLLY
Middle Name:M
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7237 SW 28TH AVE
Mailing Address - Street 2:SUITE 400 PORTLAND TRAUMA RECOVERY
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-2590
Mailing Address - Country:US
Mailing Address - Phone:503-333-0543
Mailing Address - Fax:503-245-1323
Practice Address - Street 1:7409 SW CAPITOL HWY
Practice Address - Street 2:STE 201
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-2432
Practice Address - Country:US
Practice Address - Phone:503-406-8064
Practice Address - Fax:503-245-1323
Is Sole Proprietor?:No
Enumeration Date:2007-10-03
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR42911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical