Provider Demographics
NPI:1548742299
Name:MATTHEWS, AIRI GRACE (AUD)
Entity type:Individual
Prefix:
First Name:AIRI
Middle Name:GRACE
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2255 LAKE ST APT 1
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94121-1236
Mailing Address - Country:US
Mailing Address - Phone:503-440-6110
Mailing Address - Fax:
Practice Address - Street 1:1035 GRAYSON ST
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94710-2642
Practice Address - Country:US
Practice Address - Phone:510-848-4800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-29
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist