Provider Demographics
NPI:1477172278
Name:MASON, MICHELLE MARIA
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:MARIA
Last Name:MASON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 S COTTONWOOD ST
Mailing Address - Street 2:
Mailing Address - City:IOLA
Mailing Address - State:KS
Mailing Address - Zip Code:66749-3811
Mailing Address - Country:US
Mailing Address - Phone:425-268-3874
Mailing Address - Fax:
Practice Address - Street 1:20227 80TH AVE NE UNIT 62
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-5907
Practice Address - Country:US
Practice Address - Phone:425-268-3874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-11
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management