Provider Demographics
NPI:1871810515
Name:MASON, TAMARA (QBS, PMS)
Entity type:Individual
Prefix:
First Name:TAMARA
Middle Name:
Last Name:MASON
Suffix:
Gender:F
Credentials:QBS, PMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1307 LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-3978
Mailing Address - Country:US
Mailing Address - Phone:541-285-1903
Mailing Address - Fax:
Practice Address - Street 1:1307 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3978
Practice Address - Country:US
Practice Address - Phone:541-285-1903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-20
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4409 PMS174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist