Provider Demographics
NPI:1205176906
Name:MALLETT, COURTNEY (DVM)
Entity type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:
Last Name:MALLETT
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1853
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98668-1853
Mailing Address - Country:US
Mailing Address - Phone:360-694-3007
Mailing Address - Fax:360-735-7420
Practice Address - Street 1:6818 NE FOURTH PLAIN BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-7357
Practice Address - Country:US
Practice Address - Phone:360-694-3007
Practice Address - Fax:360-735-7420
Is Sole Proprietor?:No
Enumeration Date:2013-02-18
Last Update Date:2013-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAVT60277722174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian