Individual provider · Type 1 NPI

Matthew David Niswander

Addiction (Substance Use Disorder) Counselor · Portland, OR

NPI number 1174333272 Active

Practice location

10564 SE Washington St
Portland, OR 97216-2809

Call (503) 228-9229 Map

Mailing address

19565 River Rd Apt 61
Gladstone, OR 97027-2229

Specialties and licenses

TaxonomyCodeLicense
Peer Specialist 175T00000X24-CRM-3982 (OR)
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XT-25-5158 (OR)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1174333272

Matthew David Niswander's National Provider Identifier is 1174333272, issued on Jan 10, 2025. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Portland, OR. The record was last updated on Jun 24, 2025.