Provider Demographics
NPI:1184832479
Name:MASON COUNTY
Entity Type:Organization
Organization Name:MASON COUNTY
Other - Org Name:MASON COUNTY PUBLIC HEALTH
Other - Org Type:Other Name
Authorized Official - Title/Position:HEALTH OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:YU
Authorized Official - Suffix:
Authorized Official - Credentials:MSPH
Authorized Official - Phone:360-427-9670
Mailing Address - Street 1:303 N 4TH ST
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:WA
Mailing Address - Zip Code:98584-3417
Mailing Address - Country:US
Mailing Address - Phone:360-427-9670
Mailing Address - Fax:360-427-7787
Practice Address - Street 1:303 N 4TH ST
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:WA
Practice Address - Zip Code:98584-3417
Practice Address - Country:US
Practice Address - Phone:360-427-9670
Practice Address - Fax:360-427-7787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00022826251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7144405Medicaid
WA7402720Medicaid
WA7404866Medicaid
WA5044136Medicaid
WA7402720Medicaid
WA7144405Medicaid
WAG000200462Medicare PIN