Individual provider · Type 1 NPI
Matthew David Fontaine, AAS
Psychiatric/Mental Health Registered Nurse · Portland, OR
NPI number
1144515289
Active
Practice location
13317 SE Powell Blvd
Portland, OR 97236-3335
Fax (503) 760-9609
Mailing address
PO Box 8459
Portland, OR 97207-8459
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Registered Nurse Primary | 163WP0808X | 201140738RN (OR) |
Psychiatric/Mental Health Registered Nurse: Definition to come...
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About NPI 1144515289
Matthew David Fontaine, AAS's National Provider Identifier is 1144515289, issued on Jun 16, 2011. The primary taxonomy on file is Psychiatric/Mental Health Registered Nurse (163WP0808X), and the practice location is in Portland, OR. The record was last updated on Jun 16, 2011.