Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | NT 60317302 | WA |
N | 225700000X | Massage Therapist | MA 00013757 | WA |
NPI | 1104046184 |
---|---|
Provider Name | Dr. Patricia Ann Mullen |
First Address | Issaquah, WA 98027-5394 |
Second Address | Issaquah, WA 98027-5398 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2007 |
Last Update Date | 10/09/2014 |