Provider Demographics
NPI:1013595669
Name:MUELLER, MARTI BUNKER (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:MARTI
Middle Name:BUNKER
Last Name:MUELLER
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22654 SE 280TH PL
Mailing Address - Street 2:
Mailing Address - City:MAPLE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98038-5141
Mailing Address - Country:US
Mailing Address - Phone:805-423-0025
Mailing Address - Fax:
Practice Address - Street 1:22654 SE 280TH PL
Practice Address - Street 2:
Practice Address - City:MAPLE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:98038-5141
Practice Address - Country:US
Practice Address - Phone:805-423-0025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-01
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61123758163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse