Provider Demographics
NPI:1942182340
Name:J. MASON DEPASSE, MD, PC
Entity type:Organization
Organization Name:J. MASON DEPASSE, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:MASON
Authorized Official - Last Name:DEPASSE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-870-8355
Mailing Address - Street 1:19255 SW 65TH AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:TUALATIN
Mailing Address - State:OR
Mailing Address - Zip Code:97062-9712
Mailing Address - Country:US
Mailing Address - Phone:713-870-8355
Mailing Address - Fax:
Practice Address - Street 1:19255 SW 65TH AVE STE 200
Practice Address - Street 2:
Practice Address - City:TUALATIN
Practice Address - State:OR
Practice Address - Zip Code:97062-9712
Practice Address - Country:US
Practice Address - Phone:713-870-8355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-24
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty