Provider Demographics
NPI:1487845715
Name:MASON, JAMI (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:JAMI
Middle Name:
Last Name:MASON
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:JAMI
Other - Middle Name:
Other - Last Name:BUNGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHYSICAL THERAPIST
Mailing Address - Street 1:11325 QUIVAS WAY
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80234-2618
Mailing Address - Country:US
Mailing Address - Phone:303-520-2114
Mailing Address - Fax:
Practice Address - Street 1:11325 QUIVAS WAY
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80234-2618
Practice Address - Country:US
Practice Address - Phone:303-520-2114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-01
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0007970225100000X
CO79702251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000167718Medicaid