Individual
MRS. JODI LEE MULLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2118 RIVERSIDE DR, SUITE 105, MOUNT VERNON, WA 98273-5454
(360) 202-3505
(360) 424-6009
Mailing address
7075 WORLINE RD, BOW, WA 98232-9640
(360) 202-3505
(360) 424-6009
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
0206084
WA
174400000X
Specialist
Primary
MA00022122
WA
Other
Enumeration date
01/23/2009
Last updated
01/23/2009
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