Individual
BRIAN EDWARD MAHON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1230 7TH AVE, LONGVIEW, WA 98632-3166
(360) 575-4801
Mailing address
1432 WOODSIDE DR, CASTLE ROCK, WA 98611-9481
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
WA PA10001607
WA
Other
Enumeration date
08/31/2006
Last updated
07/08/2007
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