Provider Demographics
NPI:1598445397
Name:COGNIA HEALTH PLLC
Entity Type:Organization
Organization Name:COGNIA HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MATIAS
Authorized Official - Middle Name:
Authorized Official - Last Name:MASSARO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-350-9411
Mailing Address - Street 1:522 W RIVERSIDE AVE STE 8072
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-0580
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:621 PACIFIC AVE STE 17
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98402-4699
Practice Address - Country:US
Practice Address - Phone:206-350-9411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-18
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty