Provider Demographics
NPI:1700334760
Name:MUELLER, RENEE (PA-C)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:MUELLER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6002 W N RIVER DRIVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208
Mailing Address - Country:US
Mailing Address - Phone:509-482-4402
Mailing Address - Fax:509-482-5071
Practice Address - Street 1:6130 OXON HILL RD STE 202
Practice Address - Street 2:
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745-3168
Practice Address - Country:US
Practice Address - Phone:301-567-1767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-19
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPA031270363AM0700X
VA0110-005436363AM0700X
WAPA60881076363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical