Individual
BETHANY MULDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
605 S COOLIDGE ST, MOSES LAKE, WA 98837-1893
(509) 765-0674
(509) 764-0344
Mailing address
605 S COOLIDGE ST, MOSES LAKE, WA 98837-1893
(509) 765-0674
(509) 764-0344
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
OP60968552
WA
207R00000X
Internal Medicine Physician
Primary
OP60968552
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2134374
—
WA
Enumeration date
03/14/2016
Last updated
12/05/2019
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