Provider Demographics
NPI:1740546753
Name:MASON, CINTIA (QMHP)
Entity type:Individual
Prefix:
First Name:CINTIA
Middle Name:
Last Name:MASON
Suffix:
Gender:F
Credentials:QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9830 NE CASCADES PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97220-6834
Mailing Address - Country:US
Mailing Address - Phone:503-239-8101
Mailing Address - Fax:503-408-5021
Practice Address - Street 1:9830 NE CASCADES PKWY STE 200
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97220-6834
Practice Address - Country:US
Practice Address - Phone:503-239-8101
Practice Address - Fax:503-408-5021
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-03
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG60190868106H00000X
101YA0400X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)