Provider Demographics
NPI:1790140200
Name:HALL-MULLEN, ALLISON (LMT)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:HALL-MULLEN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36105 N DEMOSS RD
Mailing Address - Street 2:
Mailing Address - City:BENTON CITY
Mailing Address - State:WA
Mailing Address - Zip Code:99320-8796
Mailing Address - Country:US
Mailing Address - Phone:509-308-0880
Mailing Address - Fax:
Practice Address - Street 1:515 N NEEL ST STE C105
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-2259
Practice Address - Country:US
Practice Address - Phone:509-783-4994
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-28
Last Update Date:2015-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60568350225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist