Healthcare Provider Details

I. General information

NPI: 1598192635
Provider Name (Legal Business Name): MONICA LYNN HULL PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2013
Last Update Date: 03/25/2025
Certification Date: 03/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7998 S 1300 E
SANDY UT
84094-0744
US

IV. Provider business mailing address

PO BOX 3777
PORTLAND OR
97208-3777
US

V. Phone/Fax

Practice location:
  • Phone: 801-255-2000
  • Fax: 801-325-7185
Mailing address:
  • Phone: 503-413-3900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA223704
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number8793909-1206
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: