Provider Demographics
NPI:1184942328
Name:MASON, DAWN ALISON
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:ALISON
Last Name:MASON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:ALISON
Other - Last Name:DILLARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 2115
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98401-2115
Mailing Address - Country:US
Mailing Address - Phone:509-310-3492
Mailing Address - Fax:
Practice Address - Street 1:7610 W NOB HILL BLVD UNIT 23
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98908-5716
Practice Address - Country:US
Practice Address - Phone:509-310-3492
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-12
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP00003076101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)