Provider Demographics
NPI:1619985728
Name:MULLIN, MICHAEL SEAN (DO)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:SEAN
Last Name:MULLIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 SUMMITVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-2715
Mailing Address - Country:US
Mailing Address - Phone:509-574-6000
Mailing Address - Fax:509-225-2714
Practice Address - Street 1:1470 N 16TH AVE
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-1381
Practice Address - Country:US
Practice Address - Phone:509-574-6000
Practice Address - Fax:509-225-2714
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP00001742208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation