Individual
MASON MINTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMP
Contact information
Practice address
1151 COMMERCE AVE, LONGVIEW, WA 98632-3024
(360) 636-3313
Mailing address
1151 COMMERCE AVE, LONGVIEW, WA 98632-3024
(360) 636-3313
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA60219037
WA
Other
Enumeration date
01/13/2012
Last updated
01/13/2012
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