Provider Demographics
NPI:1649250945
Name:MATTHEWS, JOY E (MD)
Entity type:Individual
Prefix:DR
First Name:JOY
Middle Name:E
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JOY
Other - Middle Name:E
Other - Last Name:WIENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:505 NE 87TH AVE
Mailing Address - Street 2:SUITE 160
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98664-4897
Mailing Address - Country:US
Mailing Address - Phone:360-514-1060
Mailing Address - Fax:360-514-1065
Practice Address - Street 1:505 NE 87TH AVE
Practice Address - Street 2:SUITE 160
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98664-4897
Practice Address - Country:US
Practice Address - Phone:360-514-1060
Practice Address - Fax:360-514-1065
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2013-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00036875207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8257362Medicaid
WA8257362Medicaid
WAG8885663Medicare PIN