Provider Demographics
NPI:1922758655
Name:MULLEN, ROSS (DC)
Entity Type:Individual
Prefix:
First Name:ROSS
Middle Name:
Last Name:MULLEN
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 1:1737 N WENATCHEE AVE STE E
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-1189
Mailing Address - Country:US
Mailing Address - Phone:150-988-8018
Mailing Address - Fax:506-888-0188
Practice Address - Street 1:1737 N WENATCHEE AVE STE E
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-1189
Practice Address - Country:US
Practice Address - Phone:509-888-0188
Practice Address - Fax:509-471-1094
Is Sole Proprietor?:No
Enumeration Date:2022-03-25
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH61274877111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor