Provider Demographics
NPI:1811075823
Name:MASON, ALIAGE S (LMP)
Entity type:Individual
Prefix:MRS
First Name:ALIAGE
Middle Name:S
Last Name:MASON
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 S 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-3538
Mailing Address - Country:US
Mailing Address - Phone:509-969-8789
Mailing Address - Fax:509-469-9258
Practice Address - Street 1:307 S 3RD AVE
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-3538
Practice Address - Country:US
Practice Address - Phone:509-969-8789
Practice Address - Fax:509-469-9258
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2014-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00012646174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist