Individual provider Active NPI

Thelben Mullett, MD

  • Pediatrics Physician
  • Seattle, WA
National Provider Identifier
1063830438
Registry record updated Jun 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD60754595 Issued in WA
Practice address
4744 41St Ave SW Ste 101
Seattle, WA 98116-4566
Phone
(206) 320-5780
Fax
(206) 320-5794
NPI assigned
Apr 2, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD60754595 WA Primary

Addresses

Primary practice location

4744 41St Ave SW Ste 101
Seattle, WA 98116-4566

Mailing address

PO Box 25608
Salt Lake City, UT 84125-0608
Phone (206) 320-4476

Other identifiers 1

IdentifierTypeStateIssuer
2036291MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171122001015 WA Practitioner - Pediatric Medicine 2567783871 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD60754595WAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Seattle Children'S Hospital Current Accepting new patients
The Association of Chrmc and University Physicians Pediatrics CurrentSince Jun 20, 2019 Accepting new patients
Kaiser Foundation Health Plan of Washington Current Accepting new patients
Seattle Childrens Hospital CurrentSince Feb 10, 2023 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Oct 21, 2017 Accepting new patients
Association of CHMC and University Physicians Pediatrics CurrentSince Jun 20, 2019 Accepting new patients
Swedish Health Services Pediatrics Current Accepting new patients
Swedish Health Services CurrentSince Jan 6, 2025 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Oct 21, 2017 Accepting new patients
Swedish Health Services CurrentSince Jan 6, 2025 Accepting new patients

Locations

1035 116th Ave NE
Bellevue, WA 98004
Phone (425) 451-4141

900 Pacific Ave
Ste 100
Everett, WA 98201
Phone (425) 304-6080

13020 Meridian Ave S
Everett, WA 98208
Phone (425) 357-3700

11511 NE 10th St
Hunts Point, WA 98004
Phone (425) 502-3000

8232 W Grandridge Blvd
Kennewick, WA 99336
Phone (509) 582-1700

1801 Lind Ave SW
Renton, WA 98057

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

2450 33rd Ave W
Ste 100
Seattle, WA 98199
Phone (206) 320-3364

4744 41st Ave SW
Ste 101
Seattle, WA 98116
Phone (206) 320-5780

1959 NE Pacific St
Seattle, WA 98195
Phone (206) 598-4333

4800 Sand Point Way NE
Seattle, WA 98105
Phone (206) 526-2000

4800 Sand Point Way NE
#7830
Seattle, WA 98105
Phone (206) 987-2525

1780 NW Myhre Rd
Ste 2120
Silverdale, WA 98383
Phone (360) 782-3100

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Interoperability endpoints

  • Direct secure messaging: tburrell680646@wm.providencedirect.org

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1396396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750982400000",
    "number": "1063830438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25608",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841250608",
            "telephone_number": "206-320-4476",
            "fax_number": "206-568-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4744 41ST AVE SW STE 101",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981164566",
            "telephone_number": "206-320-5780",
            "fax_number": "206-320-5794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLETT",
        "first_name": "THELBEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-02",
        "last_updated": "2025-06-27",
        "certification_date": "2025-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD60754595",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2036291",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.