Provider Demographics
NPI:1972490688
Name:MAWHINNEY, COLLIN
Entity type:Individual
Prefix:
First Name:COLLIN
Middle Name:
Last Name:MAWHINNEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:985 WIGWAM PKWY UNIT 5107
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-6838
Mailing Address - Country:US
Mailing Address - Phone:253-651-2067
Mailing Address - Fax:
Practice Address - Street 1:985 WIGWAM PKWY UNIT 5107
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-6838
Practice Address - Country:US
Practice Address - Phone:253-651-2067
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-24
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program