Individual
MALLORY R MUMMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
209 LILLY RD NE STE B, OLYMPIA, WA 98506-5030
(360) 413-8250
Mailing address
1203 EBBETS DR SW, TUMWATER, WA 98512-4606
(503) 805-0845
Taxonomy
Speciality
Code
Description
License number
State
163WG0100X
Gastroenterology Registered Nurse
60412207
WA
363LG0600X
Gerontology Nurse Practitioner
Primary
AP70030539
WA
Other
Enumeration date
06/18/2025
Last updated
08/11/2025
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