Provider Demographics
NPI:1801031737
Name:OXILES, MATTHEW ORLANDO (ARNP)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:ORLANDO
Last Name:OXILES
Suffix:
Gender:M
Credentials:ARNP
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Other - Credentials:
Mailing Address - Street 1:18 NW 20TH AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BATTLE GROUND
Mailing Address - State:WA
Mailing Address - Zip Code:98604-4175
Mailing Address - Country:US
Mailing Address - Phone:360-952-4457
Mailing Address - Fax:360-828-7409
Practice Address - Street 1:18 NW 20TH AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:BATTLE GROUND
Practice Address - State:WA
Practice Address - Zip Code:98604-4175
Practice Address - Country:US
Practice Address - Phone:360-952-4457
Practice Address - Fax:360-828-7409
Is Sole Proprietor?:No
Enumeration Date:2008-12-05
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2008034308363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1801031737Medicaid
WA1801031737Medicaid