JUAN MATA
Counselor - Mental Health
Active
Individual
NPI: 1790563864
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Counselor - Mental Health | 101YM0800X | Yes | PROFESSIONALLICENSE () |
Frequently Asked Questions
NPI 1790563864 is the National Provider Identifier for JUAN MATA, a Counselor - Mental Health provider located in Fairview, OR. This NPI was enumerated on September 19, 2023.
JUAN MATA practices at 1945 NE 205TH AVE, Fairview, OR 97024.
Quick Facts
- NPI
- 1790563864
- Type
- Individual
- Enumerated
- Sep 19, 2023
- Last Updated
- Aug 19, 2025
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