Provider Demographics
NPI:1992184360
Name:MUELLER, JOHN
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:
Last Name:MUELLER
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 1:1414 N HOUK RD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99216-1097
Mailing Address - Country:US
Mailing Address - Phone:509-755-5560
Mailing Address - Fax:509-755-5561
Practice Address - Street 1:1414 N HOUK RD
Practice Address - Street 2:SUITE 208
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-1097
Practice Address - Country:US
Practice Address - Phone:509-755-5560
Practice Address - Fax:509-755-5561
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-19
Last Update Date:2015-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAA1 605434302255A2300X
IDAT-5022255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer