MEDICARE: MASON J PLATT DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	OS010378L	PA
2	207X00000X	Orthopaedic Surgery Physician	OP60210160	WA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PL034986	OTHER	PA	MEDICARE-DME NCS
2	P00400345	OTHER	PA	MEDICARE-RAILROAD

General Provider Information

NPI Number	:	1063440048
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MASON J PLATT DO

Provider Business Mailing Address
First Line	:	4545 POINT FOSDICK DR NW
Second Line	:	SUITE 250
City	:	GIG HARBOR
State	:	WA
Zip	:	98335-1700
Country	:	US
Telephone Number	:	253-459-7000
Fax Number	:

Provider Business Practice Location Address
First Line	:	4545 POINT FOSDICK DR NW
Second Line	:	SUITE 250
City	:	GIG HARBOR
State	:	WA
Zip	:	98335-1700
Country	:	US
Telephone Number	:	253-459-7000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/29/2006
Last Update Date	:	02/15/2012

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Directions to “ MASON J PLATT DO” Practice Location

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