Individual provider Active NPI

Mason Muske Melbuer

  • Pharmacy
  • Spokane, WA
National Provider Identifier
1417547712
Registry record updated Jan 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
61076113 Issued in WA
Practice address
2105 E Wellesley Ave
Spokane, WA 99207-4271
Phone
(509) 483-0342
NPI assigned
Jan 20, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 61076113 WA Primary

Addresses

Primary practice location

2105 E Wellesley Ave
Spokane, WA 99207-4271

Mailing address

7410 S Hayford Rd Apt A301
Spokane, WA 99224-9818
Phone (360) 609-2481

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
61076113WAMDPharmacy

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Pharmacy PastSince Jan 24, 2021 Accepting new patients
Walgreen Co Pharmacy PastSince Jan 24, 2021 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1611100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611100800000",
    "number": "1417547712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7410 S HAYFORD RD APT A301",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992249818",
            "telephone_number": "360-609-2481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 E WELLESLEY AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992074271",
            "telephone_number": "509-483-0342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELBUER",
        "first_name": "MASON",
        "middle_name": "MUSKE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-20",
        "last_updated": "2021-01-20",
        "certification_date": "2021-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "WA",
            "license": "61076113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.