Provider Demographics
NPI:1063440048
Name:PLATT, MASON J (DO)
Entity type:Individual
Prefix:
First Name:MASON
Middle Name:J
Last Name:PLATT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4545 POINT FOSDICK DR NW
Mailing Address - Street 2:SUITE 250
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-1700
Mailing Address - Country:US
Mailing Address - Phone:253-459-7000
Mailing Address - Fax:
Practice Address - Street 1:4545 POINT FOSDICK DR NW
Practice Address - Street 2:SUITE 250
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-1700
Practice Address - Country:US
Practice Address - Phone:253-459-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS010378L207X00000X
WAOP60210160207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPL034986OtherMEDICARE-DME NCS
PAP00400345OtherMEDICARE-RAILROAD
PAPL034986OtherMEDICARE-DME NCS
034986EKXMedicare PIN