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Individual

GREGORY GERALD MULLINS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMT, LPN

Contact information

Practice address
1409 FRANKLIN ST STE 103, VANCOUVER, WA 98660-2860
(707) 480-4671
Mailing address
305 PACIFIC AVE N APT 102, KELSO, WA 98626-3417
(707) 480-4671

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP00045933
WA
225700000X
Massage Therapist
MA60021990
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
MULLIGG369BR
WA
Enumeration date
09/04/2019
Last updated
04/15/2025
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