Individual ProviderMathias M GreenCounselorBehavioral Health & Social Service ProvidersPractice Address419 E 7th St Ste 207, The Dalles, OR 97058-2676(541) 296-5452(541) 858-8170PECOS EnrollmentBased on the most recent information from CMS, provider Mathias M Green does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1003321753Provider TypeIndividualFull NameGreen, Mathias MGenderMaleSole ProprietorNoEnumeration Date12/4/2017Last Updated5/20/2019Contact InformationPractice LocationPractice Address419 E 7th St Ste 207, The Dalles, OR 97058-2676Phone(541) 296-5452Fax(541) 296-1537Mailing LocationMailing Address3587 Heathrow Way, Medford, OR 97504-4004Phone(541) 858-8170Fax(541) 858-8167Provider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer