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1255193785
MASON D SPONG
PORTLAND, OR
NPI
1255193785
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: OR 214752)
Enumeration Date
2024-01-30
Last Update Date
2024-05-30
Business Address
MASON D SPONG PA-C
2701 NW VAUGHN ST STE 470
PORTLAND, OR 97210-5326
Phone number: 503-751-2216
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Mailing Address
MASON D SPONG PA-C
3265 NE ALBERTA ST
PORTLAND, OR 97211-7040
Phone number: 985-264-4859
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