OrganizationAmanda Matje Pa-C PllcPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address7600 N 15th St, Phoenix, AZ 85020-4327(602) 395-0718PECOS EnrollmentBased on the most recent information from CMS, provider Amanda Matje Pa-C Pllc 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 20 days ago.Profile DetailsProvider ID1962148791Provider TypeOrganizationFull NameAmanda Matje Pa-C PllcSubpartNoEnumeration Date5/5/2022Last Updated5/5/2022Contact InformationPractice LocationPractice Address7600 N 15th St, Phoenix, AZ 85020-4327Phone(602) 395-0718FaxUnlisted FaxMailing LocationMailing AddressPO Box 39179, Phoenix, AZ 85069-9179Phone(602) 395-0718FaxUnlisted FaxAuthorized OfficialNameKoziol, Vanessa (Credentialing)Phone(480) 376-6456Provider TaxonomiesCodeDescriptionLicenseCode363A00000XPrimaryDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerIDPENDDescriptionOtherIssuerPENDArizona