Individual
MOLLY QUINN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
900 N ORANGE ST STE 304, MISSOULA, MT 59802-2951
(406) 329-5781
(406) 327-3331
Mailing address
PO BOX 12, LIBERTY LAKE, WA 99019-0012
(406) 329-5781
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
28303
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1619302742
—
MT
01
—
M011004058
MEDICARE
MT
Enumeration date
09/09/2013
Last updated
11/23/2021
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