Healthcare Provider Details

I. General information

NPI: 1336085596
Provider Name (Legal Business Name): BRIAN MASON AEMT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13023 NE HIGHWAY 99 STE 7
VANCOUVER WA
98686-2699
US

IV. Provider business mailing address

13023 NE HWY 99 STE 7 #808
VANCOUVER WA
98686
US

V. Phone/Fax

Practice location:
  • Phone: 503-708-1907
  • Fax:
Mailing address:
  • Phone: 503-708-1907
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146M00000X
TaxonomyIntermediate Emergency Medical Technician
License Number136520
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: