Healthcare Provider Details
I. General information
NPI: 1225975584
Provider Name (Legal Business Name): KENDRICK MASON PRODUCTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/03/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
206 W 8TH AVE APT 20
SPOKANE WA
99204-2427
US
IV. Provider business mailing address
206 W 8TH AVE APT 20
SPOKANE WA
99204-2427
US
V. Phone/Fax
- Phone: 901-930-5571
- Fax:
- Phone: 901-930-5571
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 175T00000X |
| Taxonomy | Peer Specialist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KENDRICK
ODELL
MASON
Title or Position: CEO
Credential:
Phone: 901-930-5571