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Derric K Matteson, LMP

Mechanotherapist in Tacoma, WA. Individual provider (NPI-1).

NPI number1881919082
StatusActive
Last updated in NPPESMar 30, 2010

Details

NPI
1881919082
Entity type
Individual (NPI-1)
Name
Mr. Derric K Matteson
Credential
LMP
Sex
Male
Sole proprietor
Yes
Enumeration date
Mar 30, 2010
Last updated
Mar 30, 2010

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
172M00000X MechanotherapistMA60101907WAYes

Practice location

8432 6th Ave Apt 4
Tacoma, WA 98465-1056

Phone 253-579-8664

Mailing address

8432 6th Ave Apt 4
Tacoma, WA 98465-1056

Phone 253-579-8664

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