Provider Demographics
NPI:1629326897
Name:MATTHIES, JASON
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:
Last Name:MATTHIES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8461 TURNPIKE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-4378
Mailing Address - Country:US
Mailing Address - Phone:303-519-9054
Mailing Address - Fax:
Practice Address - Street 1:8461 TURNPIKE DR STE 100
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-4378
Practice Address - Country:US
Practice Address - Phone:303-519-9054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-20
Last Update Date:2012-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health