Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mason D Spong, PA-C

Individual provider Physician Assistant · NPI 1255193785

Mason D Spong, PA-C is a Physician Assistant in Portland, Oregon. Graduated from Louisiana State University School of Medicine in New Orleans in 2023, 3 years ago. Practices with Active Recovery TMS PLLC, a 7-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Oregon.

Years since qualifying
3
Trained at
Louisiana State University School of Medicine in New Orleans
Licensed in
OR
In the registry since
2024
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

2701 NW Vaughn St Ste 470
Portland, OR 97210-5326
Phone: (503) 751-2216
Fax: (503) 296-2022
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 214752 (OR)

Record details

NPI number1255193785
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJanuary 30, 2024
Last updated in NPPESMay 30, 2024
Certification dateMay 30, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolLOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS
Graduated 2023 (3 years in practice)
Group practice Active Recovery Tms Pllc — 7 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

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