Individual
MR. MASON CLARKE HARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
F.N.P.
Contact information
Practice address
3144 STATE ST, MEDFORD, OR 97504-8450
(541) 226-9840
(541) 226-9846
Mailing address
1833 NEBRASKA AVE, GRANTS PASS, OR 97527-5701
(541) 226-9840
(541) 226-9846
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
200550153NP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
026845
—
OR
01
—
DU9308
RAILROAD MEDICARE GRP
OR
01
—
P01349583
RAILROAD MEDICARE IND
OR
Enumeration date
07/28/2006
Last updated
12/08/2022
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