Inna A Mulyarchuk, LMP
Individual provider Active NPI Specialist · Auburn, WA
NPI 1902137458 · NPPES record last updated Jan 22, 2010
Key facts
- NPI
- 1902137458
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- MA60118676 (WA)
- Practice address
- 12821 SE 301St St
Auburn, WA 98092-2187 - Phone
- (253) 886-9336
- NPI assigned
- Jan 22, 2010
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA60118676 | WA | MD | Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MA60118676 | WA | Yes |
Addresses
Primary practice location
12821 SE 301St St
Auburn, WA 98092-2187
Mailing address
12821 SE 301St St
Auburn, WA 98092
Phone (253) 886-9336
Other providers in Auburn, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 22, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.