Provider Demographics
NPI:1750158465
Name:DODD, MATTHEW H
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:H
Last Name:DODD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:461 VENTURA AVE
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-3536
Mailing Address - Country:US
Mailing Address - Phone:541-515-1110
Mailing Address - Fax:
Practice Address - Street 1:576 OLIVE ST STE 307
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2995
Practice Address - Country:US
Practice Address - Phone:541-344-7303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-04
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health