Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Juan Mata

Individual provider Mental Health Counselor · NPI 1790563864

Juan Mata is a Mental Health Counselor in Fairview, Oregon. Registered with an NPI since 2023.

In the registry since
2023

Practice location Address checks out

1945 NE 205th Ave
Fairview, OR 97024-9622
Phone: (503) 661-8050
Fax: (503) 492-4651
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence PROFESSIONALLICENSE

Record details

NPI number1790563864
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedSeptember 19, 2023
Last updated in NPPESAugust 19, 2025
Certification dateSeptember 19, 2023
Mailing address3587 Heathrow Way, Medford, OR 97504-4004

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