Individual provider Active NPI

Lauren Nicole Mullins

  • Physician Assistant
  • Lakewood, WA
National Provider Identifier
1376285700
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
61572999 Issued in WA
Practice address
7502 Lakewood Dr W Ste a
Lakewood, WA 98499-8410
Phone
(253) 572-2842
NPI assigned
Apr 7, 2022
Last updated
Aug 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 60966 CA
Physician Assistant 363A00000X 61572999 WA Primary

Addresses

Primary practice location

7502 Lakewood Dr W Ste a
Lakewood, WA 98499-8410

Mailing address

7502 Lakewood Dr W Ste a
Lakewood, WA 98499-8410
Phone (253) 572-2842

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240927002959 WA Practitioner - Physician Assistant 7810428091 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pace Dermatology Associates, PLLCGroup PAC ID 5193995777, 14 clinicians

Practice addresses (Care Compare)

1901 S Union Ave
Suite B3003
Tacoma, WA 98405-1803

1910 S Meridian
Puyallup, WA 98371-7531
Phone (253) 572-2842

7502 Lakewood Dr W
Suite a
Lakewood, WA 98499-8410
Phone (253) 572-2842

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
60966CAMDPhysician Assistant
61572999WAMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: lmullins@directaddress.net

Organizations & group practices 1

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1649289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1376285700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7502 LAKEWOOD DR W STE A",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984998410",
            "telephone_number": "253-572-2842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7502 LAKEWOOD DR W STE A",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984998410",
            "telephone_number": "253-572-2842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLINS",
        "first_name": "LAUREN",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-07",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "60966",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "61572999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, WA

Sources for this page

Verify at the official NPI Registry.