Provider Demographics
NPI:1043691728
Name:FILOON, MATTHEW (FNP)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:FILOON
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4749
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97501-0227
Mailing Address - Country:US
Mailing Address - Phone:541-789-4111
Mailing Address - Fax:541-789-5518
Practice Address - Street 1:3011 E BARNETT RD
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504
Practice Address - Country:US
Practice Address - Phone:541-789-4673
Practice Address - Fax:541-789-2121
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-17
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201503391 NP-PP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily