Lisa Michelle Matiaco, PA-C

Individual provider Physician Assistant · NPI 1154500536

Lisa Michelle Matiaco, PA-C is a Physician Assistant in Republic, Washington. Qualified in 2007, 19 years ago. Practices with Optimal Health of Southern Oregon, LLC, a 2-clinician group and accepts Medicare assignment.

Years since qualifying: 19
In the registry since: 2007

What do these letters mean?

PA-C — Physician Assistant, Certified: A physician assistant who holds current national certification.

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Practice location Address checks out

10 Ros Cir
Republic, WA 99166-5002
Phone: (509) 775-3153
Fax: (509) 775-8929

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

Specialties & licences

Physician Assistant (primary)	Taxonomy 363A00000X

Record details

NPI number	1154500536
Entity type	Individual (Type 1)
Gender	Female
Credentials	PA-C
Sole proprietor	No
NPI enumerated	November 1, 2007
Last updated in NPPES	March 21, 2013

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialty	PHYSICIAN ASSISTANT
Medical school	OTHER
Graduated	2007 (19 years in practice)
Group practice	Optimal Health Of Southern Oregon, Llc — 2 clinicians
Accepts Medicare assignment	Yes — accepts the Medicare-approved amount