Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | MD00038847 | WA |
NPI | 1013982636 |
---|---|
Provider Name | John Steele Mullen |
First Address | Seattle, WA 98104-1172 |
Second Address | Seattle, WA 98104-2120 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/02/2006 |
Last Update Date | 28/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H25228 | (02) |