Provider Demographics
NPI:1457905531
Name:MATTHEWS, JULIA LEINANI
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:LEINANI
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16265 NW SPYGLASS DR
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97006-7726
Mailing Address - Country:US
Mailing Address - Phone:503-277-8929
Mailing Address - Fax:
Practice Address - Street 1:16265 NW SPYGLASS DR
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006-7726
Practice Address - Country:US
Practice Address - Phone:503-277-8929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-28
Last Update Date:2019-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer