MASON CARL HAYCOCK (NPI# 1326483769) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326483769 |
| Entity Type | Individual |
| Full Name | MASON CARL HAYCOCK |
| Credential | CCP |
| Practice Address |
10180 Se Sunnyside Rd Clackamas OR 97015-8970 |
| Mailing Address |
1237 Goose Creek Rd Woodburn OR 97071-9682 |
| Practice Telephone | 5036522880 |
| Mailing Telephone | 5593038985 |
| Enumeration Date | 2013-04-29 |
| Last Update Date | 2013-04-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282N00000X | General Acute Care Hospital | Hospitals |
| Street Address |
10180 SE SUNNYSIDE RD |
| City | CLACKAMAS |
| State | OR |
| Zip Code | 97015-8970 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407855786 | Kevin C La Cour | Radiology | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2005-07-19 |
| 1588270466 | Jacob Aaron Stutheit | Student in an Organized Health Care Education/Training Program | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2020-09-16 |
| 1023633005 | Jeremy Ward | Student in an Organized Health Care Education/Training Program | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2020-06-15 |
| 1336761998 | Maksim Ivan Yablonsky | Technician, Other | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2020-05-17 |
| 1497389811 | Clifford Andrew Moore | Student in an Organized Health Care Education/Training Program | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2020-02-25 |
| 1417580622 | Taryn Dee | Surgery | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2020-02-16 |
| 1881225241 | Jocelyn Mason | Pharmacist | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2020-02-03 |
| 1760022461 | Katie Keim | Social Worker | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2020-01-09 |
| 1346887668 | Hannah N. Schroeder | Registered Nurse | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2019-12-05 |
| 1164072286 | Thien-huong Theresa Van | Student in an Organized Health Care Education/Training Program | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2019-09-19 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184103517 | Laurel Perilli | Physical Therapist | 12550 Se 93rd Ave Ste 265, Clackamas, OR 97015 | 2018-08-07 |
| 1306324538 | Kristin Connor Messing | Physical Therapist | 4805 Ne Glisan St, Prov Hall 7e06, Portland, OR 97015 | 2018-07-31 |
| 1902317266 | Darcy Jones Hamrick | Counselor | 12901 Se 97th Ave., Suite 340, Clackamas, OR 97015 | 2017-10-13 |
| 1841723384 | Manon Lavoie | Chiropractor | 17105 Se Sunnyside Rd, Suite 148, Happy Valley, OR 97015 | 2017-04-11 |
| 1235670126 | Michael G Short | Pedorthist | 10117 Se Sunnyside Rd., Ste. H, Clackamas, OR 97015 | 2017-03-13 |
| 1487100756 | Michael Joseph Peizner | Pharmacist | 16300se Evelyn Street, Clackamas, OR 97015 | 2016-08-28 |
| 1316395619 | Jennifer Elaine Walkowski | Physical Therapist | 9100 Se Sunnyside Road, Clackamas, OR 97015 | 2016-05-26 |
| 1649635384 | Brookside Dental - Milwaukie, LLC | Dentist | 9225 Se Sunnyside Rd. Ste 1, Clackamas, OR 97015 | 2015-12-23 |
| 1801216130 | Robert D. Grew Dmd, Inc. | Dentist | 10163 Se Sunnyside Road, Suite 414, Clackamas, OR 97015 | 2014-04-25 |
| 1508205410 | Valerie P Tabalno | Massage Therapist | 15661 Se 82nd Dr, Clackamas, OR 97015 | 2013-06-25 |
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| Taxonomy Code | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528179090 | David Allen Siegel | General Acute Care Hospital | 10810 Se Sunnyside Rd, Clackamas, OR 97015-9787 | 2006-08-31 |
| 1326282880 | Kaiser Permanente | General Acute Care Hospital | 10180 Se Sunnyside Rd Fl 1, Clackamas, OR 97015-8970 | 2009-04-28 |
| 1598917866 | Kaiser Permenente Sunnyside Medical Center | General Acute Care Hospital | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2008-10-18 |
| 1407007636 | Kaiser Permanente | General Acute Care Hospital | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2008-10-07 |
| 1083872972 | Kaiser Permanente | General Acute Care Hospital | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2008-05-28 |
| 1124182902 | Kaiser Foundation Hospitals | General Acute Care Hospital | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2006-12-19 |
| 1770685281 | Greg Jay Passmore | General Acute Care Hospital | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2006-09-04 |
| 1124134127 | Kaiser Permanente | General Acute Care Hospital | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2006-08-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447665526 | Linda Damaskos | General Acute Care Hospital | 310 Nw Upyown Terrace, 2a, Portland, OR 97210 | 2014-06-26 |
| 1003246174 | Rebecca Changizian | General Acute Care Hospital | 2929 Ne 25th Ave, Portland, OR 97212-3460 | 2013-11-26 |
| 1023440435 | Providence Health & Services - Oregon | General Acute Care Hospital | 11445 Se Moon Dust Ct, Happy Valley, OR 97086-8033 | 2013-08-08 |
| 1235483199 | Kaiser Sunnyside Medical Center | General Acute Care Hospital | 3480 Mock Orange Ct S, Salem, OR 97302-3647 | 2012-10-30 |
| 1891048807 | Kaiser Foundation Hospitals | General Acute Care Hospital | 2875 Nw Stucki Ave., Hillsboro, OR 97124-5806 | 2012-10-16 |
| 1710241922 | Silverton Hospital | General Acute Care Hospital | 700 Sw Lupine Ct, Sublimity, OR 97385-9509 | 2012-07-02 |
| 1215213756 | Northwest Association of Surgical Assistants, Inc. | General Acute Care Hospital | 3782 Po Box, Springfield, OR 97475 | 2011-10-28 |
| 1194024760 | Lisa Marie Arbuckle | General Acute Care Hospital | 16105 Sw 108th Ave, Apt. 212, Tigard, OR 97224-4870 | 2011-03-22 |
| 1679879662 | Veterans Hospital | General Acute Care Hospital | 3710 S.w. U.S. Veterans Road, Portland, OR 97239-2964 | 2011-02-08 |
| 1083866933 | Providence St Vincent Hospital | General Acute Care Hospital | 1235 Ne 47th Ave, Suite 285, Portland, OR 97213-2100 | 2008-10-22 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.