National Provider Identifier
Mattison Lee Wallin, PA-C
Mattison Lee Wallin, PA-C is listed in the NPPES registry with a primary specialty of Physician Assistant in Jamestown, NY and a listed phone number of (716) 484-4334.
Profile Overview
- NPI
- 1255210480
- Provider Type
- Individual
- Primary Specialty
- Physician Assistant
- Enumeration Date
- September 01, 2025
- Last Updated
- September 01, 2025
Practice Location
- 107 Institute St
- Jamestown, NY 14701-6628
Phone: (716) 484-4334
Mailing Address
- 1958 Peterson RD
- Russell, PA 16345-7040
Specialties
- Physician Assistant (363A00000X)
Full Record
- NPI
- 1255210480
- Entity Type
- Individual
- Last Name
- Wallin
- First Name
- Mattison
- Middle Name
- Lee
- Credential
- PA-C
- Mailing Street Address
- 1958 Peterson RD
- Mailing City
- Russell
- Mailing State
- PA
- Mailing ZIP Code
- 16345-7040
- Mailing Country
- US
- Mailing Phone
- (814) 688-8867
- Practice Street Address
- 107 Institute St
- Practice City
- Jamestown
- Practice State
- NY
- Practice ZIP Code
- 14701-6628
- Practice Country
- US
- Practice Phone
- (716) 484-4334
- Enumeration Date
- September 01, 2025
- Last Updated
- September 01, 2025
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- September 01, 2025
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Physician Assistant (363A00000X)