MEDICARE: STANLEY E MASON R.PH.

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	183500000X	Pharmacist	PH00010876	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PH00010876	OTHER	WA	WA PHARMACIST LICENSE

General Provider Information

NPI Number	:	1114040193
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STANLEY E MASON R.PH.

Provider Business Mailing Address
First Line	:	7109 N MONROE ST
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99208-6238
Country	:	US
Telephone Number	:	509-465-0396
Fax Number	:	509-483-0343

Provider Business Practice Location Address
First Line	:	7109 N MONROE ST
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99208-6238
Country	:	US
Telephone Number	:	509-465-0396
Fax Number	:	509-483-0343

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

Provider Enumeration Date	:	04/06/2007
Last Update Date	:	12/07/2025

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