Individual
JERMAINE CHRISTOPHER MASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PEER SUPPORT SPECIAL
Contact information
Practice address
3311 NE MARTIN LUTHER KING JR BLVD STE 104, PORTLAND, OR 97212-2086
(503) 206-8856
(503) 327-8318
Mailing address
3311 NE MARTIN LUTHER KING JR BLVD STE 104, PORTLAND, OR 97212-2086
(503) 206-8856
(503) 327-8318
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
THW000004033
OR
Other
Enumeration date
04/01/2020
Last updated
04/01/2020
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