Individual
NICHOLAS CARL MULL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRM
Contact information
Practice address
1011 COMMERCIAL ST NE, SALEM, OR 97301-1049
(503) 983-9900
(503) 983-9899
Mailing address
1011 COMMERCIAL ST NE, SALEM, OR 97301-1049
(503) 983-9900
(503) 983-9899
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
21-CRM-652
OR
Other
Enumeration date
12/17/2021
Last updated
02/08/2022
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