Individual
MASON CARL HAYCOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CCP
Contact information
Practice address
10180 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-8970
(503) 652-2880
Mailing address
1237 GOOSE CREEK RD, WOODBURN, OR 97071-9682
(559) 303-8985
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Enumeration date
04/29/2013
Last updated
04/29/2013
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