Provider Demographics
NPI:1336344944
Name:OSWIN, MATTHEW M (DO)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:M
Last Name:OSWIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5096
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98227-5096
Mailing Address - Country:US
Mailing Address - Phone:360-733-2092
Mailing Address - Fax:360-733-4013
Practice Address - Street 1:3015 SQUALICUM PARKWAY
Practice Address - Street 2:SUITE 200
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225
Practice Address - Country:US
Practice Address - Phone:360-733-2092
Practice Address - Fax:360-733-4013
Is Sole Proprietor?:No
Enumeration Date:2007-06-15
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP00002206207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5889OSOtherREGENCE
WA8480477Medicaid
WA0219234OtherL&I AND CRIME VICTIMS
WA1336344944Medicaid
WA7130916OtherAETNA
WAG8865887Medicare PIN