Individual
PHYLLIS ANN MASON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
3057 ROAD H NE, #49, MOSES LAKE, WA 98837-9609
(509) 760-6948
Mailing address
PO BOX 1291, MOSES LAKE, WA 98837-0197
(509) 760-6948
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OC00000635
WA
Other
Enumeration date
12/13/2012
Last updated
12/13/2012
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