Provider Demographics
NPI:1073999165
Name:MCMULLIN, MATTHEW DEE (DC)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:DEE
Last Name:MCMULLIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21707 103RD AVENUE CT E
Mailing Address - Street 2:SUITE B201
Mailing Address - City:GRAHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98338-8308
Mailing Address - Country:US
Mailing Address - Phone:253-655-7262
Mailing Address - Fax:
Practice Address - Street 1:21707 103RD AVENUE CT E
Practice Address - Street 2:SUITE B201
Practice Address - City:GRAHAM
Practice Address - State:WA
Practice Address - Zip Code:98338-8308
Practice Address - Country:US
Practice Address - Phone:253-655-7262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-30
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH 60536551111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor