Provider Demographics
NPI:1104046184
Name:MULLEN, PATRICIA ANN (ND)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:ANN
Last Name:MULLEN
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:PATTI
Other - Middle Name:
Other - Last Name:ROGERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MAGUIRE
Mailing Address - Street 1:1420 NW GILMAN BLVD # 2156
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-5394
Mailing Address - Country:US
Mailing Address - Phone:425-590-7684
Mailing Address - Fax:
Practice Address - Street 1:1505 NW GILMAN BLVD
Practice Address - Street 2:SUITE 3
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-5398
Practice Address - Country:US
Practice Address - Phone:425-590-7684
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT 60317302175F00000X
WAMA 00013757225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist