MICHAEL L MATLOCK (NPI# 1922172592) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922172592 |
| Entity Type | Individual |
| Full Name | MICHAEL L MATLOCK |
| Credential | M.D. |
| Practice Address |
3525 Ensign Rd Ne Suite 02 Olympia WA 98506-5065 |
| Practice Telephone | 3604591213 |
| Practice Fax Number | 3604590114 |
| Mailing Telephone | 3604591213 |
| Mailing Fax Number | 3604590114 |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2008-04-02 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RI0200X |
Internal Medicine Specialization: Infectious Disease |
16540 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 1904101 | 05 |
| Street Address |
3525 ENSIGN RD NE SUITE 02 |
| City | OLYMPIA |
| State | WA |
| Zip Code | 98506-5065 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356340970 | Olympia Radiologists, P.s. | Radiology | 3525 Ensign Rd Ne, Suite B, Olympia, WA 98506-5065 | 2005-07-15 |
| 1770950669 | Theresa Erin Duggan | Nurse Practitioner | 3525 Ensign Rd Ne, Olympia, WA 98506-5065 | 2015-08-26 |
| 1801283841 | James Simmons | Nurse Practitioner | 3525 Ensign Rd Ne, Suite E, Olympia, WA 98506-5065 | 2015-04-16 |
| 1417354960 | Allison Elise Hamza | Physician Assistant | 3525 Ensign Rd Ne, Suite N, Olympia, WA 98506-5065 | 2014-11-28 |
| 1306248927 | Andrea Simmons | Nurse Practitioner | 3525 Ensign Rd Ne, Ste B, Olympia, WA 98506-5065 | 2014-09-26 |
| 1417388182 | Cynthia Marie Mosebach | Nurse Practitioner | 3525 Ensign Rd Ne, Olympia, WA 98506-5065 | 2013-12-06 |
| 1700216223 | Northwest Asthma Allergy Center | Specialist | 3525 Ensign Rd Ne, Suite E, Olympia, WA 98506-5065 | 2013-11-19 |
| 1184052128 | Stefanie Denney | Hearing Instrument Specialist | 3525 Ensign Rd Ne, M-1, Olympia, WA 98506-5065 | 2013-10-30 |
| 1396187613 | Samy's Drug Store Inc. | Pharmacy | 3525 Ensign Rd Ne, Suite H, Olympia, WA 98506-5065 | 2013-07-29 |
| 1750675609 | Niranjan Sivakumar | Internal Medicine | 3525 Ensign Rd Ne, Suite K, Olympia, WA 98506-5065 | 2011-06-07 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477185460 | Chloe Harper | Technician, Other | 3443 Lilly Rd Se, Ste B, Olympia, WA 98506 | 2020-02-07 |
| 1912543539 | Jessica Marie Radakovich | Licensed Practical Nurse | 3426 Mary Elder Rd, Olympia, WA 98506 | 2019-11-19 |
| 1669014973 | Arlene Josephine Adams | Registered Nurse | 413 Lily Rd Ne, Olympia, WA 98506 | 2019-10-09 |
| 1861999120 | Debra Delores Barker | Licensed Practical Nurse | 3710 South Bay Rd Ne, Olympia, WA 98506 | 2018-04-12 |
| 1801304431 | Michelle Warner | Nurse Practitioner | 205 Lilly Rd Ne Ste A1, Olympia, WA 98506 | 2018-01-17 |
| 1396258364 | Institute for Family Development | Community/Behavioral Health | 204 Quince St. Ne, Suite 200, Olympia, WA 98506 | 2017-11-13 |
| 1083137715 | Cameron Kunkel | Specialist/Technologist | 2512 20th Ave Ne, Olympia, WA 98506 | 2017-07-25 |
| 1184144768 | Trevor Shane Kwan | Family Medicine | 525 Lilly Road Ne, Olympia, WA 98506 | 2017-06-23 |
| 1073043212 | Michael H Harburg | Behavior Technician | 3857 Martin Way Ne, Olympia, WA 98506 | 2017-06-19 |
| 1780114371 | Priscilla Kangyang Jadu | Counselor | 3857 Martin Way E., Olympia, WA 98506 | 2017-06-15 |
| Find all providers in zip 98506 | ||||
| Taxonomy Code | 207RI0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Infectious Disease |
| An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548344823 | Britta L Denman | Internal Medicine | 3920 Capital Mall Dr Sw Ste 402, Olympia, WA 98502-8703 | 2006-10-24 |
| 1205099181 | Preeti Kondal | Internal Medicine | 3525 Ensign Rd Ne Ste R, Pmg Sw Wa Olympia Infectious Diseases, Olympia, WA 98506-5065 | 2008-07-09 |
| 1508061656 | Dana R Saunders | Internal Medicine | 3525 Ensign Rd Ne Ste R, Pmg Sw Wa Olympia Infectious Diseases, Olympia, WA 98506-5065 | 2007-06-19 |
| 1750455317 | Steven M Standaert | Internal Medicine | 3525 Ensign Rd Ne Ste R, Pmg Sw Wa Olympia Infectious Diseases, Olympia, WA 98506-5065 | 2006-11-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417509746 | In Kwon Park Md Pllc | Internal Medicine | 11216 Sunrise Blvd E Ste 3-103, Puyallup, WA 98374-8848 | 2019-07-16 |
| 1982146072 | Barbara Kirby | Internal Medicine | 11111 Wachusett Rd, Woodway, WA 98020-6143 | 2016-11-07 |
| 1679961130 | Everett Infectious Diseases, Pllc | Internal Medicine | 717 Nw 190th Ln, Shoreline, WA 98177-3055 | 2015-01-06 |
| 1467726893 | Lynn Frumkin | Internal Medicine | 2543 1/2 56th Ave Sw, Seattle, WA 98116-2219 | 2012-03-02 |
| 1700181435 | Edward Lawrence Weber | Internal Medicine | 4109 Boulevard Place, Mercer Island, WA 98040-3403 | 2011-01-11 |
| 1437452034 | Neron Balassanian | Internal Medicine | 10650 Ne 9th Pl Unit 2322, Bellevue, WA 98004-5080 | 2010-12-21 |
| 1366764284 | Patrick O'malley Tennican | Internal Medicine | 665 N. Riverpoint Blvd., Suite 410, Spokane, WA 99202-1665 | 2010-02-19 |
| 1982854352 | Diego Lopez De Castilla | Internal Medicine | 12303 Ne 130th Ln Ste Coral120, Kirkland, WA 98034 | 2008-09-23 |
| 1982852554 | Reena K. Gulati | Internal Medicine | 701 5th Avenue, Seattle, WA 98104 | 2008-09-08 |
| 1215198254 | Jason W Van Winkle | Internal Medicine | 12303 Ne 130th Ln Ste 120, Kirkland, WA 98034 | 2008-06-23 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.