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General NPI Number Information
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NPI Number | 1841189735
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Entity Type | Individual
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Provider Name | MASON SNODGRASS PT
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Gender | Male
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Dates
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Enumeration Date | 07/02/2025
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 2737 77TH AVE SE STE 214
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City | MERCER ISLAND
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State | WA
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Zip | 98040-2832
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Country | US
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Telephone | 206-518-9405
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Fax |
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Provider Business Mailing Address
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Address Line | 500 MONROE AVE NE APT G12
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City | RENTON
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State | WA
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Zip | 98056-8489
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Country | US
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Telephone | 707-799-8120
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number | PT.PT.70007689
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License Number State | WA
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