Matsumoto, Travis
Matsumoto, Travis is an individual health care provider with primary practice located at 920 Country Club Rd Ste 200A , Eugene OR 97401-6086. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is his primary health care specialty. Matsumoto, Travis can be contacted via phone (541) 242-4220.Contact Information
Primary practice address
920 Country Club Rd Ste 200A
Eugene OR 97401-6086
Phone: (541) 242-4220
Fax: (541) 686-6021
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | PA156342 | Oregon |
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | PA156342 |
Profile Details
| NPI number | 1972875334 |
|---|---|
| LBN Legal business name | Matsumoto, Travis |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 1st, 2012 |
| Last updated | Oct 31st, 2014 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1972875334 | NPPES |
| Oregon | Other | PA156342 | STATE LICENSE |
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