Provider Demographics
NPI:1891442166
Name:HELLEM, MATTHEW GARRETT (DC)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:GARRETT
Last Name:HELLEM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 HALL RD
Mailing Address - Street 2:
Mailing Address - City:SILVERLAKE
Mailing Address - State:WA
Mailing Address - Zip Code:98645-9788
Mailing Address - Country:US
Mailing Address - Phone:360-270-4944
Mailing Address - Fax:
Practice Address - Street 1:820 OCEAN BEACH HWY STE 116
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632-4081
Practice Address - Country:US
Practice Address - Phone:360-414-3220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-07
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61262775111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor