Provider Demographics
NPI:1912130436
Name:MITCHELL, HELEN VIGINIA (LMP)
Entity Type:Individual
Prefix:MS
First Name:HELEN
Middle Name:VIGINIA
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29702 132ND AVE SE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98092-2137
Mailing Address - Country:US
Mailing Address - Phone:206-909-5840
Mailing Address - Fax:253-939-4020
Practice Address - Street 1:23639 126TH AVE SE
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98031-3701
Practice Address - Country:US
Practice Address - Phone:206-909-5840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-01
Last Update Date:2009-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00008680171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor