Provider Demographics
NPI:1801782503
Name:MATTEUCCI, MATTHEW (DACM)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:MATTEUCCI
Suffix:
Gender:M
Credentials:DACM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1106 HARRIS AVE STE 305
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-7002
Mailing Address - Country:US
Mailing Address - Phone:650-922-1883
Mailing Address - Fax:
Practice Address - Street 1:1106 HARRIS AVE STE 305
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-7002
Practice Address - Country:US
Practice Address - Phone:650-922-1883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAACUP.AC.61437270171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist