Healthcare Provider Details

I. General information

NPI: 1003494881
Provider Name (Legal Business Name): ALEXA MASON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2021
Last Update Date: 10/03/2024
Certification Date: 10/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2671 NE 46TH ST
SEATTLE WA
98105-5041
US

IV. Provider business mailing address

2671 NE 46TH ST
SEATTLE WA
98105-5041
US

V. Phone/Fax

Practice location:
  • Phone: 206-525-8000
  • Fax: 206-525-8070
Mailing address:
  • Phone: 206-525-8000
  • Fax: 206-525-8070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number61529615
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: