Provider Demographics
NPI:1780074278
Name:MULLEN, PATRICIA (MA)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:MULLEN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2510 N PINES RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99206-7636
Mailing Address - Country:US
Mailing Address - Phone:509-928-3015
Mailing Address - Fax:509-928-3042
Practice Address - Street 1:2510 N PINES RD
Practice Address - Street 2:SUITE 201
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-7636
Practice Address - Country:US
Practice Address - Phone:509-928-3015
Practice Address - Fax:509-928-3042
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-04
Last Update Date:2015-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACL60166839101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor