Provider Demographics
NPI:1386698900
Name:MASON, WENDY ANNE (ARNP)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:ANNE
Last Name:MASON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 W MARINA DR
Mailing Address - Street 2:HOUSE #28
Mailing Address - City:MOSES LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:98837-3920
Mailing Address - Country:US
Mailing Address - Phone:509-764-0186
Mailing Address - Fax:
Practice Address - Street 1:832 SHARON AVE E
Practice Address - Street 2:SUITE D
Practice Address - City:MOSES LAKE
Practice Address - State:WA
Practice Address - Zip Code:98837-2442
Practice Address - Country:US
Practice Address - Phone:509-764-4800
Practice Address - Fax:509-764-4801
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30007159363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health